Active NPI
Health Paradigm, LLC
- Psychiatry Physician
- Ruston, LA
National Provider Identifier
1235340761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 1164R
- Legal business name
- HEALTH PARADIGM, LLC
- Practice address
- 615 S Trenton St
Ruston, LA 71270-5040 - Phone
- (318) 251-2322
- Fax
- (318) 251-0710
- NPI assigned
- May 25, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elisa M Vandenberg
- Title
- Administrator
- Phone
- (318) 251-2322
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CI 3505 LA | LA | |
| Psychiatry Physician | 2084P0800X | 1164R | LA | Primary |
Addresses
Primary practice location
615 S Trenton St
Ruston, LA 71270-5040
Mailing address
615 S Trenton St
Ruston, LA 71270-5040
Phone (318) 251-2322
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1681032 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Health Paradigm LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Non-emergency Medical Transport (VAN)
- Ruston, LA
- NPI 1902007941
Locations
615 S Trenton St
Ruston, LA 71270
Phone (318) 251-2322
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatry Physician
- Ruston, LA
- NPI 1558397109
-
- Professional Counselor
- Ruston, LA
- NPI 1144507187
-
- Professional Counselor
- Ruston, LA
- NPI 1750698890
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1283299200000",
"number": "1235340761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 S TRENTON ST",
"city": "RUSTON",
"state": "LA",
"postal_code": "712705040",
"telephone_number": "318-251-2322",
"fax_number": "318-251-0710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 S TRENTON ST",
"city": "RUSTON",
"state": "LA",
"postal_code": "712705040",
"telephone_number": "318-251-2322",
"fax_number": "318-251-0710"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTH PARADIGM, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-25",
"last_updated": "2010-09-01",
"status": "A",
"authorized_official_last_name": "VANDENBERG",
"authorized_official_first_name": "ELISA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "318-251-2322"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor",
"state": "LA",
"license": "CI 3505 LA",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "LA",
"license": "1164R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1681032",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ruston, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.