NPIMap

Organization Active NPI

Renick P Webb MD a Professional Medical Corporation

  • Otolaryngology Physician
  • Alexandria, LA
National Provider Identifier
1235129883
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
017368 Issued in LA
Legal business name
RENICK P WEBB MD A PROFESSIONAL MEDICAL CORPORATION
Practice address
221 Windermere Blvd
Alexandria, LA 71303-3538
Phone
(318) 443-9773
Fax
(318) 443-9799
NPI assigned
Oct 25, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Authorized official

Name
Renick P Webb, M.D.
Title
President
Phone
(318) 427-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X 017368 LA Primary

Addresses

Primary practice location

221 Windermere Blvd
Alexandria, LA 71303-3538

Mailing address

221 Windermere Blvd
Alexandria, LA 71303-3538
Phone (318) 443-9773

Other identifiers 1

IdentifierTypeStateIssuer
1440094MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320019200000",
    "number": "1235129883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 WINDERMERE BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033538",
            "telephone_number": "318-443-9773",
            "fax_number": "318-443-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 WINDERMERE BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033538",
            "telephone_number": "318-443-9773",
            "fax_number": "318-443-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENICK P WEBB MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2011-10-31",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "RENICK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-427-3300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "017368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1440094",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.