NPIMap

Organization Active NPI

Magnolia Medical, LLC

  • Prosthetic/Orthotic Supplier
  • Lafayette, LA
National Provider Identifier
1174094304
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MAGNOLIA MEDICAL, LLC
Practice address
626 Verot School Rd Ste C
Lafayette, LA 70508-5094
Phone
(337) 210-2060
Fax
(888) 544-6008
NPI assigned
Dec 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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

Authorized official

Name
Marissa Beesley
Title
Billing Manager
Phone
(601) 442-6493

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

626 Verot School Rd Ste C
Lafayette, LA 70508-5094

Mailing address

5412 Dijon Dr
Baton Rouge, LA 70808-4315
Phone (225) 615-8693

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Medical LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

626 Verot School Rd
Ste C
Lafayette, LA 70508
Phone (337) 210-2060

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544918400000",
    "number": "1174094304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 DIJON DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084315",
            "telephone_number": "225-615-8693",
            "fax_number": "888-544-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 VEROT SCHOOL RD STE C",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085094",
            "telephone_number": "337-210-2060",
            "fax_number": "888-544-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A",
        "authorized_official_last_name": "BEESLEY",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "601-442-6493"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.