Individual provider Active NPI

Maria de Los Angeles Pons, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Slidell, LA
National Provider Identifier
1154492221
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
MD.13867R Issued in LA
Practice address
105 Medical Center Dr
Suite 306
Slidell, LA 70461-5544
Phone
(985) 643-3033
Fax
(985) 643-3099
NPI assigned
Nov 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X MD.13867R LA Primary

Addresses

Primary practice location

105 Medical Center Dr
Suite 306
Slidell, LA 70461-5544

Mailing address

105 Medical Center Dr Ste 306
Slidell, LA 70461-5539
Phone (985) 649-0076

Other identifiers 2

IdentifierTypeStateIssuer
00124265MedicaidMS
1183296MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.13867RLAMDNeurology with Special Qualifications in Child Neurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1154492221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MEDICAL CENTER DR STE 306",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615539",
            "telephone_number": "985-649-0076",
            "fax_number": "985-643-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MEDICAL CENTER DR",
            "address_2": "SUITE 306",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615544",
            "telephone_number": "985-643-3033",
            "fax_number": "985-643-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONS",
        "first_name": "MARIA DE LOS",
        "middle_name": "ANGELES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-12",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "LA",
            "license": "MD.13867R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124265",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1183296",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.