NPIMap

Organization Active NPI

Lakeside Women's Specialty Center, Apmc

  • Obstetrics & Gynecology Physician
  • Metairie, LA
National Provider Identifier
1104907807
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
LAKESIDE WOMEN'S SPECIALTY CENTER, APMC
Practice address
4315 Houma Blvd
Suite 500
Metairie, LA 70006-2940
Phone
(504) 885-8563
Fax
(504) 455-1072
NPI assigned
Oct 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kathryn G Wild, M.D.NPI 1750341939
Title
President
Phone
(504) 885-8563

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

4315 Houma Blvd
Suite 500
Metairie, LA 70006-2940

Mailing address

4315 Houma Blvd
Suite 500
Metairie, LA 70006-2940
Phone (504) 885-8563

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104907807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 HOUMA BLVD",
            "address_2": "SUITE 500",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062940",
            "telephone_number": "504-885-8563",
            "fax_number": "504-455-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 HOUMA BLVD",
            "address_2": "SUITE 500",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062940",
            "telephone_number": "504-885-8563",
            "fax_number": "504-455-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE WOMEN'S SPECIALTY CENTER, APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILD",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-885-8563",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.