Louisiana Retina a Professional Medical Corporation

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

LOUISIANA RETINA A PROFESSIONAL MEDICAL CORPORATION

Practice address

303 Veterans Blvd Ste a
Denham Springs, LA 70726-4723

Phone

(225) 242-9729

NPI assigned

Oct 19, 2020

Organization subpart

No

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

Authorized official

Name

Jordan Burnham, MDNPI 1427312800

Title

Owner

Phone

(225) 523-7624

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: dkilpatrick@laretina.intellechartdirect.net

Practitioners 2

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

• Jordan M Burnham, M.D.

  • Ophthalmology Physician
  • Denham Springs, LA
  • NPI 1427312800
  Medicare reassignment Care Compare group NPD Authorized official
• David Kilpatrick, MD

  • Retina Specialist (Ophthalmology) Physician
  • Denham Springs, LA
  • NPI 1225449317
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1235738634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 VETERANS BLVD STE A",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707264723",
            "telephone_number": "225-242-9729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 VETERANS BLVD STE A",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707264723",
            "telephone_number": "225-242-9729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4545 Bluebonnet Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708095602",
            "country_code": "US",
            "telephone_number": "225-523-7624",
            "fax_number": "225-523-7625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LOUISIANA RETINA A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "BURNHAM",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-523-7624",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@louisianaretina.com",
            "affiliation": "N",
            "address_1": "303 Veterans Blvd Ste A",
            "city": "Denham Springs",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707264723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Ophthalmology Physician in Denham Springs, LA
• Providers in Denham Springs, LA by specialty
• Ophthalmology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.

Verify at the official NPI Registry.