Minden Internal Medicine & Pediatrics, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MINDEN INTERNAL MEDICINE & PEDIATRICS, LLC

Practice address

101 Office Park Dr
Minden, LA 71055-3088

Phone

(318) 377-2979

Fax

(318) 377-2596

NPI assigned

Jan 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kelly M Carlisle, MD

Title

Owner

Phone

(318) 377-2979

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Wilma Lynette Maynor, FNP-C

  • Family Nurse Practitioner
  • Springhill, LA
  • NPI 1982660627
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1154300275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 OFFICE PARK DR",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710553088",
            "telephone_number": "318-377-2979",
            "fax_number": "318-377-2596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OFFICE PARK DR",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710553088",
            "telephone_number": "318-377-2979",
            "fax_number": "318-377-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDEN INTERNAL MEDICINE & PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "CARLISLE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-377-2979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minden Family Medicine LLC
• Minden Family Pharmacy LLC (Minden Family Pharmacy)
• Minden Foot Clinic, Inc
• Minden Home Health Services, Inc. (Professional Home Health of Minden)
• Minden Homecare Equipment & Uniforms
• Minden Medical Center
• Minden Orthopaedics & Rehab Services, LLC
• Minden Orthopaedics, Apmc
• Minden Physical Therapy LLC
• Minden Physician Practices LLC (Louisiana Foot and Ankles Center)

• Internal Medicine Physician in Minden, LA
• Providers in Minden, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.