NPIMap

Organization Active NPI

North Caddo Medical Center Healthplex

  • Public Health or Welfare Agency
  • Vivian, LA
National Provider Identifier
1124155411
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
210A Issued in LA
Legal business name
NORTH CADDO MEDICAL CENTER HEALTHPLEX
Practice address
102 Industrial Drive
Vivian, LA 71082
Phone
(318) 375-2808
Fax
(318) 375-5032
NPI assigned
Feb 27, 2007
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
Mr. David Jones, CEO
Title
Administrator
Phone
(318) 375-3235

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 210A LA Primary

Addresses

Primary practice location

102 Industrial Drive
Vivian, LA 71082

Mailing address

102 Industrial Drive
P.O. Box 952
Vivian, LA 71082
Phone (318) 375-2808

National Provider Directory

National Provider Directory
Tax ID family
N Caddo Medical Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

102 Industrial Dr
Vivian, LA 71082
Phone (318) 375-2808

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124155411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 INDUSTRIAL DRIVE",
            "address_2": "P.O. BOX 952",
            "city": "VIVIAN",
            "state": "LA",
            "postal_code": "71082",
            "telephone_number": "318-375-2808",
            "fax_number": "318-375-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 INDUSTRIAL DRIVE",
            "city": "VIVIAN",
            "state": "LA",
            "postal_code": "71082",
            "telephone_number": "318-375-2808",
            "fax_number": "318-375-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CADDO MEDICAL CENTER HEALTHPLEX",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-375-3235",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "LA",
            "license": "210A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vivian, 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.