Individual provider Active NPI

Myron Ernest Moorehead II, MD

  • Gynecology Physician
  • Kenner, LA
National Provider Identifier
1104993708
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD4222R Issued in LA
Practice address
200 W Esplanade Ave
Suite 311
Kenner, LA 70065-2474
Phone
(504) 467-0770
Fax
(504) 467-0791
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X MD4222R LA Primary

Addresses

Primary practice location

200 W Esplanade Ave
Suite 311
Kenner, LA 70065-2474

Mailing address

200 W Esplanade Ave
Suite 311
Kenner, LA 70065-2474
Phone (504) 467-0770

Other identifiers 1

IdentifierTypeStateIssuer
092522606OtherLACONTROLLED SUBSTANCE LIC

Other names 1

  • Myron E Moorehead MD Apmc Professional name

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
MD4222RLAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Pharmacy and Wellness, LLC Past Accepting new patients
Myron E Moorehead MD Apmc Gynecology PastSince Jan 30, 2017 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1104993708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ESPLANADE AVE",
            "address_2": "SUITE 311",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652474",
            "telephone_number": "504-467-0770",
            "fax_number": "504-467-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ESPLANADE AVE",
            "address_2": "SUITE 311",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652474",
            "telephone_number": "504-467-0770",
            "fax_number": "504-467-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOREHEAD",
        "first_name": "MYRON",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "LA",
            "license": "MD4222R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LIC",
            "identifier": "092522606",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRON",
            "last_name": "MOOREHEAD MD APMC",
            "middle_name": "E",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Kenner, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.