NPIMap

Organization Active NPI

Our Lady of Lake Ascension, LLC

Doing business as St Elizabeth Physicians DSME Program

  • Health Educator
  • Gonzales, LA
National Provider Identifier
1114201399
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
OUR LADY OF LAKE ASCENSION, LLC
Doing business as
St Elizabeth Physicians DSME Program
Practice address
2647 S Saint Elizabeth Blvd
Gonzales, LA 70737-5021
Phone
(225) 647-8511
NPI assigned
Oct 5, 2011
Last updated
Oct 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Authorized official

Name
John Frederick Fraiche, M.D.
Title
President
Phone
(225) 647-8511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X Primary

Addresses

Primary practice location

2647 S Saint Elizabeth Blvd
Gonzales, LA 70737-5021

Mailing address

2647 S Saint Elizabeth Blvd
Gonzales, LA 70737-5021
Phone (225) 647-8511

Other names 1

  • St Elizabeth Physicians DSME Program Doing business as

National Provider Directory

National Provider Directory

Locations

1024 E Ascension Complex Blvd
Gonzales, LA 70737
Phone (225) 644-2616

2647 S Saint Elizabeth Blvd
Ste 125
Gonzales, LA 70737
Phone (225) 647-9675

16171 State Bank Dr
Ste 200
Prairieville, LA 70769
Phone (225) 677-9595

17609 Old Jefferson Hwy
Ste F
Prairieville, LA 70769

40195 Highway 42
Prairieville, LA 70769
Phone (225) 622-4343

Practitioners & affiliated clinicians

Practitioners 5

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": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1114201399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2647 S SAINT ELIZABETH BLVD",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707375021",
            "telephone_number": "225-647-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 S SAINT ELIZABETH BLVD",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707375021",
            "telephone_number": "225-647-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF LAKE ASCENSION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "FRAICHE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-647-8511",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Elizabeth Physicians DSME Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.