NPIMap

Organization Active NPI

Cerebral Palsy Association of G.B.R., Inc.

  • Multi-Specialty Clinic/Center
  • Baton Rouge, LA
National Provider Identifier
1144224031
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CEREBRAL PALSY ASSOCIATION OF G.B.R., INC.
Doing business as
MCMAINS CHILDREN'S DEVELOPMENTAL CENTER
Practice address
1805 College Dr
Baton Rouge, LA 70808-1919
Phone
(225) 923-3420
Fax
(225) 922-9316
NPI assigned
Jun 8, 2005
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
Ms. Janet C. Ketcham, LCSW
Title
Executive Director
Phone
(225) 923-3420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1805 College Dr
Baton Rouge, LA 70808-1919

Mailing address

1805 College Dr
Baton Rouge, LA 70808-1919
Phone (225) 923-3420

Other identifiers 3

IdentifierTypeStateIssuer
1394149MedicaidLA
02587OtherLABLUE CROSS PROVIDER
1930423MedicaidLA

Other names 1

  • MCMAINS CHILDREN'S DEVELOPMENTAL CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cerebral Palsy Association of GBR Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144224031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 COLLEGE DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708081919",
            "telephone_number": "225-923-3420",
            "fax_number": "225-922-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 COLLEGE DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708081919",
            "telephone_number": "225-923-3420",
            "fax_number": "225-922-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEREBRAL PALSY ASSOCIATION OF G.B.R., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KETCHAM",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "225-923-3420",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1394149",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER",
            "identifier": "02587",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1930423",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCMAINS CHILDREN'S DEVELOPMENTAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.