NPIMap

Organization Active NPI

Louisiana Ear, Nose, Throat & Sinus, LLC

  • Otolaryngology Physician
  • Baton Rouge, LA
National Provider Identifier
1114483872
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
LOUISIANA EAR, NOSE, THROAT & SINUS, LLC
Practice address
8080 Bluebonnet Blvd Ste 2121
Baton Rouge, LA 70810-7830
Phone
(225) 408-6900
Fax
(225) 408-6946
NPI assigned
Feb 18, 2019
Last updated
Sep 27, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Authorized official

Name
Ms. Edie C Scully-Tucker
Title
Director of Operations
Phone
(225) 408-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

8080 Bluebonnet Blvd Ste 2121
Baton Rouge, LA 70810-7830

Mailing address

8080 Bluebonnet Blvd Ste 2222
Baton Rouge, LA 70810-7828
Phone (225) 408-6900

Other practice location 1

5258 Dijon Dr
Baton Rouge, LA 70808-4311
Phone (225) 408-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190620002368 LA Part B Supplier - Clinic/Group Practice 9335473685 Receives reassigned benefits from 28 practitioners
Practice locations: Baton Rouge, LA; Denham Springs, LA; St. Francisville, LA; Zachary, LA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

15280 NW 79th Ct
Ste 200
Miami Lakes, FL 33016

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569542400000",
    "number": "1114483872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 BLUEBONNET BLVD STE 2222",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107828",
            "telephone_number": "225-408-6900",
            "fax_number": "225-408-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 BLUEBONNET BLVD STE 2121",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107830",
            "telephone_number": "225-408-6900",
            "fax_number": "225-408-6946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5258 Dijon Dr",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084311",
            "country_code": "US",
            "telephone_number": "225-408-6900",
            "fax_number": "225-408-6946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LOUISIANA EAR, NOSE, THROAT & SINUS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-18",
        "last_updated": "2019-09-27",
        "status": "A",
        "authorized_official_last_name": "SCULLY-TUCKER",
        "authorized_official_first_name": "EDIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "225-408-6900",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.