NPIMap

Organization Active NPI

Our Lady of the Lake Ascension, LLC

Doing business as St Elizabeth Physicians Specialists

  • Surgery Physician
  • Gonzales, LA
National Provider Identifier
1144468422
Registry record updated Jun 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
026022 Issued in LA
Legal business name
OUR LADY OF THE LAKE ASCENSION, LLC
Doing business as
St Elizabeth Physicians Specialists
Practice address
2647 S Riverview Blvd
Gonzales, LA 70737-5021
Phone
(225) 647-8511
Fax
(225) 644-5213
NPI assigned
Jan 26, 2009
Organization subpart
Yes
Parent organization
OUR LADY OF THE LAKE ASCENSION COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2009

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

Authorized official

Name
Dr. John F Fraiche, M.D.NPI 1043218886
Title
President
Phone
(225) 743-2651

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 12027R LA
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X R001375 LA
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 04796R LA
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 026022 LA Primary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X 024919 LA

Addresses

Primary practice location

2647 S Riverview Blvd
Gonzales, LA 70737-5021

Mailing address

2647 S. Riverview Blvd
Gonzales, LA 70737
Phone (225) 647-8511

Other names 1

  • St Elizabeth Physicians Specialists Doing business as

National Provider Directory

National Provider Directory
Part of
St Elizabeth Hospital

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243987200000",
    "number": "1144468422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2647 S. RIVERVIEW BLVD",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "70737",
            "telephone_number": "225-647-8511",
            "fax_number": "225-644-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 S RIVERVIEW BLVD",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707375021",
            "telephone_number": "225-647-8511",
            "fax_number": "225-644-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF THE LAKE ASCENSION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUR LADY OF THE LAKE ASCENSION COMMUNITY HOSPITAL",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-06-03",
        "status": "A",
        "authorized_official_last_name": "FRAICHE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-743-2651",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "LA",
            "license": "12027R",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "LA",
            "license": "R001375",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "LA",
            "license": "04796R",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "LA",
            "license": "026022",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "LA",
            "license": "024919",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Elizabeth Physicians Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; 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.