Eric J Melancon M D LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ERIC J MELANCON M D LLC

Doing business as

Tiger Island Medical Clinic

Practice address

1151 Marguerite St
Suite 200a
Morgan City, LA 70380-1850

Phone

(985) 384-7288

Fax

(985) 384-7291

NPI assigned

Jan 9, 2009

Organization subpart

Yes

Parent organization

ERIC J MELANCON MD LLCAs reported in NPPES

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

Authorized official

Name

Eric Joseph Melancon, MDNPI 1609955137

Title

President

Phone

(985) 384-7288

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tiger Island Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Part of

Eric J Melancon M D LLC

Practitioners 1

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

• Eric Joseph Melancon, M.D.

  • Internal Medicine Physician
  • Morgan City, LA
  • NPI 1609955137
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1215174420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 MARGUERITE ST",
            "address_2": "SUITE 200A",
            "city": "MORGAN CITY",
            "state": "LA",
            "postal_code": "703801850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 MARGUERITE ST",
            "address_2": "SUITE 200A",
            "city": "MORGAN CITY",
            "state": "LA",
            "postal_code": "703801850",
            "telephone_number": "985-384-7288",
            "fax_number": "985-384-7291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC J MELANCON M D LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ERIC J MELANCON MD LLC",
        "enumeration_date": "2009-01-09",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "MELANCON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-384-7288",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215174420",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tiger Island Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Morgan City, LA
• Providers in Morgan City, 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 Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.