Individual provider Active NPI

Bruce Merle Lovelace III

  • Periodontics
  • Baton Rouge, LA
National Provider Identifier
1245329713
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
LA3170 Issued in LA
Practice address
8202 Kelwood Ave
Baton Rouge, LA 70806-4801
Phone
(225) 928-0798
Fax
(225) 927-8115
NPI assigned
Oct 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X LA3170 LA Primary

Addresses

Primary practice location

8202 Kelwood Ave
Baton Rouge, LA 70806-4801

Mailing address

8202 Kelwood Ave
Baton Rouge, LA 70806-4801
Phone (225) 928-0798

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3170LAMDAddiction (Substance Use Disorder) Counselor
LA3170LAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Bruce M Lovelace III a Professional Corporation Periodontics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245329713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8202 KELWOOD AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708064801",
            "telephone_number": "225-928-0798",
            "fax_number": "225-927-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 KELWOOD AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708064801",
            "telephone_number": "225-928-0798",
            "fax_number": "225-927-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELACE",
        "first_name": "BRUCE",
        "middle_name": "MERLE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "LA",
            "license": "LA3170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.