Northshore Provider Group LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

NORTHSHORE PROVIDER GROUP LLC

Practice address

48529 Red Fox Dr
Hammond, LA 70401-3715

Phone

(337) 315-9686

NPI assigned

Aug 30, 2016

Last updated

Aug 30, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James I Mathews

Title

Owner

Phone

(337) 315-9686

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1285180158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1063",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704041063",
            "telephone_number": "337-315-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48529 RED FOX DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704013715",
            "telephone_number": "337-315-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE PROVIDER GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "MATHEWS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-315-9686",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northshore ENT Clinic, LLC
• Northshore Eye Associates LLC
• Northshore Hospital Medicine LLC
• Northshore Imaging Assoc LLC
• Northshore Internal Medicine Associates
• Kristin Toney Notariano, DOCTOR OF PHARMACY
• NS'NG, Inc. (Hammond Nursing Home)
• Jamonica Nunnery
• Brittany Laine O'Bryan, DIETITIAN
• Elizabeth Hagan O'Krepki, MS, CCC-SLP

• Nurse Practitioner in Hammond, LA
• Providers in Hammond, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.

Verify at the official NPI Registry.