NPIMap

Individual provider Active NPI

Fakhre Fakhre, M.D.

  • Internal Medicine Physician
  • Oak Grove, LA
National Provider Identifier
1134186133
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11307R Issued in LA
Practice address
706 Ross St
Oak Grove, LA 71263-9798
Phone
(318) 428-3237
Fax
(318) 428-6180
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11307R LA Primary

Addresses

Primary practice location

706 Ross St
Oak Grove, LA 71263-9798

Mailing address

706 Ross St
Oak Grove, LA 71263-9798
Phone (318) 428-3237

Other identifiers 1

IdentifierTypeStateIssuer
1658740MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100715000678 LA Practitioner - Internal Medicine 8325170020 Reassigns benefits to 3 organizations
Practice locations: Oak Grove, LA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Carroll Health Systems, LLCGroup PAC ID 5294627774, shared by 8 NPIs, 21 clinicians

Practice addresses (Care Compare)

706 Ross St
Oak Grove, LA 71263-9798
Phone (318) 428-3237

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11307RLAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Carroll Health Systems LLC Current Accepting new patients
West Carroll Health Systems LLC CurrentSince Dec 1, 2002 Accepting new patients
West Carroll Health Systems LLC CurrentSince Dec 1, 2002 Accepting new patients
West Carroll Care Center Inc Past Accepting new patients

Locations

706 Ross St
Oak Grove, LA 71263
Phone (318) 428-3237

712 Settoon St
Oak Grove, LA 71263
Phone (318) 428-2341

Interoperability endpoints

  • Direct secure messaging: ffakhre@wchs.securechart.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
West Carroll Care Center IncOak Grove, LA, CCN 195398 Skilled nursing facility Contracted Managing Employee (100%)
Adp of the SNF		 Jan 1, 2021
Dec 26, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1134186133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 ROSS ST",
            "city": "OAK GROVE",
            "state": "LA",
            "postal_code": "712639798",
            "telephone_number": "318-428-3237",
            "fax_number": "318-428-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 ROSS ST",
            "city": "OAK GROVE",
            "state": "LA",
            "postal_code": "712639798",
            "telephone_number": "318-428-3237",
            "fax_number": "318-428-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHRE",
        "first_name": "FAKHRE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "11307R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1658740",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Grove, LA

Sources for this page

Verify at the official NPI Registry.