Med Ed of Louisiana, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

023722 Issued in LA

Legal business name

MED ED OF LOUISIANA, INC.

Practice address

209 Champagne Blvd.
Breaux Bridge, LA 70517-3700

Phone

(337) 332-0222

Fax

(337) 332-1102

NPI assigned

Dec 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jahanyar Khorsandi, M.D.NPI 1215990932

Title

President

Phone

(337) 332-0222

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• Jahanyar Khorsandi, M.D.

  • Family Medicine Physician
  • Breaux Bridge, LA
  • NPI 1215990932
  Medicare reassignment NPD Authorized official
• Melissa Barber, NP

  • Family Nurse Practitioner
  • Opelousas, LA
  • NPI 1275099657
  NPD (past)
• Nichole Gordon Miller, FNP-C

  • Family Nurse Practitioner
  • Opelousas, LA
  • NPI 1356806830
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451520000000",
    "number": "1114086576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 CHAMPAGNE BLVD",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173700",
            "telephone_number": "337-332-0222",
            "fax_number": "337-332-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 CHAMPAGNE BLVD.",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173700",
            "telephone_number": "337-332-0222",
            "fax_number": "337-332-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED ED OF LOUISIANA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2015-12-31",
        "status": "A",
        "authorized_official_last_name": "KHORSANDI",
        "authorized_official_first_name": "JAHANYAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-332-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "023722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor McCaulley, PLPC
• Mandy Alecia McCoy, MSW, LCSW
• Cheryl M McDaniel, M.ED.,CCC-SLP
• Colin David McGibboney
• Max McLeod, P.T.
• Med-Air, LLC.
• Brenda Melancon, M.ED.
• Gladys Melancon
• Sarah Melancon, PLPC
• Jailee Menard

• Family Medicine Physician in Breaux Bridge, LA
• Providers in Breaux Bridge, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.