NPIMap

Organization Active NPI

Renal Services of Northeast Louisiana a Prof Med Corp

  • Nephrology Physician
  • Monroe, LA
National Provider Identifier
1164723920
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
18516 Issued in LA
Legal business name
RENAL SERVICES OF NORTHEAST LOUISIANA A PROF MED CORP
Practice address
1908 Royal Ave
Monroe, LA 71201-5724
Phone
(318) 325-5435
Fax
(318) 325-8852
NPI assigned
Nov 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Authorized official

Name
Dr. Larry Thomas Olinde, M.D.
Title
Physician/Owner
Phone
(318) 325-5435

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 18516 LA Primary

Addresses

Primary practice location

1908 Royal Ave
Monroe, LA 71201-5724

Mailing address

1908 Royal Ave
Monroe, LA 71201-5724
Phone (318) 325-5435

National Provider Directory

National Provider Directory

Locations

1908 Royal Ave
Monroe, LA 71201
Phone (318) 325-5435

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1164723920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 ROYAL AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015724",
            "telephone_number": "318-325-5435",
            "fax_number": "318-325-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 ROYAL AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015724",
            "telephone_number": "318-325-5435",
            "fax_number": "318-325-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL SERVICES OF NORTHEAST LOUISIANA A PROF MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "OLINDE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "318-325-5435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "18516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; 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.