NPIMap

Organization Active NPI

Westside Clinics Anc

  • Pediatrics Physician
  • Marrero, LA
National Provider Identifier
1265433320
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WESTSIDE CLINICS ANC
Practice address
4225 Lapalco Blvd
Marrero, LA 70072
Phone
(504) 391-7337
Fax
(504) 398-7213
NPI assigned
Aug 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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

Authorized official

Name
Avery H Sampson, MD
Title
Managing Physician & President
Phone
(504) 391-7337

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X Primary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080A0000X

Addresses

Primary practice location

4225 Lapalco Blvd
Marrero, LA 70072

Mailing address

P O Box 2400
Marrero, LA 70073-2400
Phone (504) 391-7337

Other identifiers 1

IdentifierTypeStateIssuer
1440574MedicaidLA

National Provider Directory

National Provider Directory

Locations

3909 Lapalco Blvd
Ste 204
Harvey, LA 70058

Practitioners & affiliated clinicians

Practitioners 9

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": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435276800000",
    "number": "1265433320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 2400",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700732400",
            "telephone_number": "504-391-7337",
            "fax_number": "504-398-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 LAPALCO BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-391-7337",
            "fax_number": "504-398-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE CLINICS ANC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2015-06-26",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "AVERY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN & PRESIDENT",
        "authorized_official_telephone_number": "504-391-7337",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1440574",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.