NPIMap

Organization Active NPI

Paradise Children's Clinic of Louisiana LLC

Doing business as Paradise Children's Clinic

  • Pediatrics Physician
  • Ball, LA
National Provider Identifier
1124457676
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PARADISE CHILDREN'S CLINIC OF LOUISIANA LLC
Doing business as
Paradise Children's Clinic
Practice address
4702 Monroe Hwy
Ball, LA 71405-3944
Phone
(318) 641-6113
Fax
(318) 641-6115
NPI assigned
Nov 5, 2013
Last updated
Nov 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Authorized official

Name
Ashley L Mason
Title
Office Manager
Phone
(318) 641-6113

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary
Family Nurse Practitioner 363LF0000X
Pediatric Nurse Practitioner 363LP0200X

Addresses

Primary practice location

4702 Monroe Hwy
Ball, LA 71405-3944

Mailing address

4702 Monroe Hwy
Ball, LA 71405-3944
Phone (318) 641-6113

Other practice location 1

5821 Monroe Hwy
Ball, LA 71405-3362
Phone (318) 641-6113

Other identifiers 1

IdentifierTypeStateIssuer
2351192MedicaidLA

Other names 1

  • Paradise Children's Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

4702 Monroe Hwy
Ball, LA 71405
Phone (318) 640-9116

Practitioners & affiliated clinicians

Practitioners 6

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": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1124457676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 MONROE HWY",
            "city": "BALL",
            "state": "LA",
            "postal_code": "714053944",
            "telephone_number": "318-641-6113",
            "fax_number": "318-641-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 MONROE HWY",
            "city": "BALL",
            "state": "LA",
            "postal_code": "714053944",
            "telephone_number": "318-641-6113",
            "fax_number": "318-641-6115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5821 Monroe Hwy",
            "address_purpose": "LOCATION",
            "city": "Ball",
            "state": "LA",
            "postal_code": "714053362",
            "country_code": "US",
            "telephone_number": "318-641-6113",
            "fax_number": "318-641-6115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PARADISE CHILDREN'S CLINIC OF LOUISIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "318-641-6113"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2351192",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paradise Children's Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ball, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.