Organization Active NPI

Gregory C Sampognaro MD

  • Specialist
  • Monroe, LA
National Provider Identifier
1235337346
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
11645R Issued in LA
Legal business name
GREGORY C SAMPOGNARO MD
Practice address
2503 Broadmoor Blvd
Monroe, LA 71201-2987
Phone
(318) 322-7726
Fax
(318) 322-2614
NPI assigned
Jul 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Authorized official

Name
Dr. Gregory C Sampognaro, M.D.NPI 1467546168
Title
MD
Phone
(318) 322-7726

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 11645R LA Primary

Addresses

Primary practice location

2503 Broadmoor Blvd
Monroe, LA 71201-2987

Mailing address

2503 Broadmoor Blvd
Monroe, LA 71201-2987
Phone (318) 322-7726

Other identifiers 3

IdentifierTypeStateIssuer
4388289030OtherLABLUE CROSS BLUE SHIELD
060061109MedicaidLA
060061109OtherLARAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1235337346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 BROADMOOR BLVD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012987",
            "telephone_number": "318-322-7726",
            "fax_number": "318-322-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 BROADMOOR BLVD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012987",
            "telephone_number": "318-322-7726",
            "fax_number": "318-322-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY C SAMPOGNARO MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "SAMPOGNARO",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "318-322-7726",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "11645R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4388289030",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060061109",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060061109",
            "state": "LA"
        }
    ],
    "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 Feb 23, 2012; 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.