NPIMap

Organization Active NPI

Northlake Radiology Consultants, Apmc

  • Diagnostic Radiology Physician
  • Slidell, LA
National Provider Identifier
1083662746
Registry record updated Jan 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTHLAKE RADIOLOGY CONSULTANTS, APMC
Practice address
1001 Gause Blvd
Slidell, LA 70458-2939
Phone
(985) 649-8545
NPI assigned
May 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Klar A Rovira IV, M.D.NPI 1922075803
Title
Partner
Phone
(985) 646-0691

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1001 Gause Blvd
Slidell, LA 70458-2939

Mailing address

PO Box 2710
Slidell, LA 70459-2710
Phone (985) 646-0691

Other identifiers 3

IdentifierTypeStateIssuer
05974773MedicaidMS
09012709MedicaidMS
08927838MedicaidMS

National Provider Directory

National Provider Directory

Locations

500 Pontchartrain Dr
#200
Slidell, LA 70458
Phone (504) 646-0691

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1083662746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2710",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704592710",
            "telephone_number": "985-646-0691",
            "fax_number": "985-646-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 GAUSE BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582939",
            "telephone_number": "985-649-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAKE RADIOLOGY CONSULTANTS, APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "ROVIRA",
        "authorized_official_first_name": "KLAR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "985-646-0691",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05974773",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09012709",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08927838",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.