Active NPI
Evangeline Clinical Services, Inc.
- Emergency Medical Services (Emergency Medicine) Physician
- Mamou, LA
National Provider Identifier
1235510280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- Legal business name
- EVANGELINE CLINICAL SERVICES, INC.
- Practice address
- 801 Poinciana Ave
Mamou, LA 70554-2243 - Phone
- (337) 468-5261
- NPI assigned
- Jun 16, 2015
- 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
- Stephen Wright
- Title
- SVP Group Operations
- Phone
- (318) 561-7191
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | Primary |
Addresses
Primary practice location
801 Poinciana Ave
Mamou, LA 70554-2243
Mailing address
80 Versailles Blvd
Suite C
Alexandria, LA 71303-3979
Other names 1
- Savoy Emergency Room Physician Group
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160223000852 | LA | Part B Supplier - Clinic/Group Practice | 3870805104 |
Receives reassigned benefits from 41 practitioners Practice locations: Mamou, LA |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Critical Access Hospital Clinic/Center
- Coushatta, LA
- NPI 1871584722
Member Of
Locations
80 Versailles Blvd
Ste C
Alexandria, LA 71303
Phone (318) 441-0800
855 Pierremont Rd
Ste 105
Shreveport, LA 71106
Phone (318) 861-7413
Practitioners & affiliated clinicians
Practitioners 42
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": "1434412800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1434412800000",
"number": "1235510280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 VERSAILLES BLVD",
"address_2": "SUITE C",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713033979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 POINCIANA AVE",
"city": "MAMOU",
"state": "LA",
"postal_code": "705542243",
"telephone_number": "337-468-5261"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVANGELINE CLINICAL SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2015-06-16",
"last_updated": "2015-06-16",
"status": "A",
"authorized_official_last_name": "WRIGHT",
"authorized_official_first_name": "STEPHEN",
"authorized_official_title_or_position": "SVP GROUP OPERATIONS",
"authorized_official_telephone_number": "318-561-7191"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Savoy Emergency Room Physician Group",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mamou, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.