Active NPI
Northeast Louisiana Radiology Associates
- Diagnostic Radiology Physician
- Ruston, LA
National Provider Identifier
1255377297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- NORTHEAST LOUISIANA RADIOLOGY ASSOCIATES
- Practice address
- 1813 Northpointe LN
Ruston, LA 71270-3879 - Phone
- (318) 255-7591
- Fax
- (318) 255-7584
- NPI assigned
- Jun 20, 2006
- 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
- Brenton McDonald, M.D.
- Title
- Physician
- Phone
- (318) 283-4483
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
1813 Northpointe LN
Ruston, LA 71270-3879
Mailing address
1813 Northpointe LN
Ruston, LA 71270-3879
Phone (318) 255-7591
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CF8948 | Other | RAILROAD MEDICARE | |
| 137419002 | Medicaid | AR | |
| 1949523 | Medicaid | LA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1459814400000",
"number": "1255377297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1813 NORTHPOINTE LN",
"city": "RUSTON",
"state": "LA",
"postal_code": "712703879",
"telephone_number": "318-255-7591",
"fax_number": "318-255-7584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1813 NORTHPOINTE LN",
"city": "RUSTON",
"state": "LA",
"postal_code": "712703879",
"telephone_number": "318-255-7591",
"fax_number": "318-255-7584"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHEAST LOUISIANA RADIOLOGY ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-20",
"last_updated": "2016-04-05",
"status": "A",
"authorized_official_last_name": "MCDONALD",
"authorized_official_first_name": "BRENTON",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "318-283-4483",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CF8948",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "137419002",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1949523",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ruston, LA
- Antoinette F Nieves, LPC
- Ella James Nimmers
- Noble Promise Christian Counseling Center
- Northeast Delta Human Services Authority (Ruston Behavioral Health Clinic)
- Northeast Delta Human Services Authority (Ruston Behavioral Health Clinic-Medical)
- Northeast Supports and Services Center
- Morgan Northen, M.A., CCC-SLP
- Northern Louisiana Emergency Physicians LLP (Northern Louisiana Physicians LLP)
- Northern Louisiana Emergency Physicians, LLP (Northern Louisiana Physicians LLP)
- Northland Hearing Centers, Inc. (Audibel Hearing Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.