Organization Active NPI

Natchitoches Medical Specialists

  • Family Medicine Physician
  • Natchitoches, LA
National Provider Identifier
1124257530
Registry record updated Oct 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NATCHITOCHES MEDICAL SPECIALISTS
Practice address
505 Royal St Ste B
Natchitoches, LA 71457-5728
Phone
(318) 352-2971
Fax
(318) 356-0850
NPI assigned
Jul 7, 2009
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Bryan A Picou, MD
Title
President
Phone
(318) 352-2971

Practitioners 4

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2330555Natchitoches Medical Specialists, LLC505 Royal St, Suite B, Natchitoches, LA 71457Certificate of waiverSep 17, 2027

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20100221000012 LA Part B Supplier - Clinic/Group Practice 5395889927 Receives reassigned benefits from 4 practitioners
Practice locations: Natchitoches, LA

National Provider Directory

National Provider Directory

Locations

1029 Keyser Ave
Ste G
Natchitoches, LA 71457
Phone (318) 325-2971

1029 Keyser Ave
Ste J
Natchitoches, LA 71457
Phone (318) 238-6001

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

505 Royal St Ste B
Natchitoches, LA 71457-5728

Mailing address

505 Royal St Ste B
Natchitoches, LA 71457-5728
Phone (318) 352-2971

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
2101803MedicaidLA
6443890001OtherLADME PTAN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 19, 2024.

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729296000000",
    "number": "1124257530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 ROYAL ST STE B",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575728",
            "telephone_number": "318-352-2971",
            "fax_number": "318-356-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 ROYAL ST STE B",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575728",
            "telephone_number": "318-352-2971",
            "fax_number": "318-356-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATCHITOCHES MEDICAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-07",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A",
        "authorized_official_last_name": "PICOU",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-352-2971",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2101803",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PTAN",
            "identifier": "6443890001",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchitoches, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2024; 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.