Active NPI
Julie D McIntosh, PAC
- Physician Assistant
- Oak Grove, LA
National Provider Identifier
1235180506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PAA10585.RX
- Practice address
- 706 Ross St
Oak Grove, LA 71263-9798 - Phone
- (318) 428-6136
- Fax
- (318) 428-6191
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAA10585.RX | LA | Primary |
Addresses
Primary practice location
706 Ross St
Oak Grove, LA 71263-9798
Mailing address
706 Ross St
Oak Grove, LA 71263-9798
Phone (318) 428-6136
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAA10585.RX | LA | MD | Physician Assistant |
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/west-7cc29999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254182400000",
"number": "1235180506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "706 ROSS ST",
"city": "OAK GROVE",
"state": "LA",
"postal_code": "712639798",
"telephone_number": "318-428-6136",
"fax_number": "318-428-6191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 ROSS ST",
"city": "OAK GROVE",
"state": "LA",
"postal_code": "712639798",
"telephone_number": "318-428-6136",
"fax_number": "318-428-6191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTOSH",
"first_name": "JULIE",
"middle_name": "D",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-12",
"last_updated": "2009-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "LA",
"license": "PAA10585.RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Grove, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.