Individual provider Active NPI

Samuel Richard Staggers, M.D.

  • Obstetrics Physician
  • Hammond, LA
National Provider Identifier
1104829613
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
L#011678 Issued in LA
Practice address
15748 Medical Arts Dr
Hammond, LA 70403-1446
Phone
(985) 542-0663
Fax
(985) 542-7010
NPI assigned
May 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X L#011678 LA Primary

Addresses

Primary practice location

15748 Medical Arts Dr
Hammond, LA 70403-1446

Mailing address

15748 Medical Arts Dr
Hammond, LA 70403-1446
Phone (985) 542-0663

Other identifiers 1

IdentifierTypeStateIssuer
1188158MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L#011678LAMDObstetrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1117411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1104829613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15748 MEDICAL ARTS DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031446",
            "telephone_number": "985-542-0663",
            "fax_number": "985-542-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15748 MEDICAL ARTS DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031446",
            "telephone_number": "985-542-0663",
            "fax_number": "985-542-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGGERS",
        "first_name": "SAMUEL",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-30",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "LA",
            "license": "L#011678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1188158",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.