Organization Active NPI

Minuteclinic Diagnostic of Louisiana, LLC

  • Family Nurse Practitioner
  • New Orleans, LA
National Provider Identifier
1285975482
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MINUTECLINIC DIAGNOSTIC OF LOUISIANA, LLC
Practice address
4401 S Claiborne Ave
New Orleans, LA 70125
Phone
(866) 389-2727
NPI assigned
Mar 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Deborah Jean Pincince
Title
Administrator
Phone
(401) 770-3813

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

4401 S Claiborne Ave
New Orleans, LA 70125

Mailing address

PO Box 772
Credentialing-MC 2295
Woonsocket, RI 02895-0784
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140128000722 LA Part B Supplier - Clinic/Group Practice 7618106477 Receives reassigned benefits from 28 practitioners
Practice locations: Baton Rouge, LA; Slidell, LA; New Orleans, LA; Metairie, LA; Covington, LA; Destrehan, LA

National Provider Directory

National Provider Directory
Tax ID family
Minuteclinic Diagnostic of Louisiana LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14360 Wax Rd
Baton Rouge, LA 70818
Phone (225) 261-6541

2915 Highway 190
Mandeville, LA 70471
Phone (985) 626-8106

2105 Cleary Ave
Metairie, LA 70001
Phone 5048828186 ext. 8221

4401 S Claiborne Ave
New Orleans, LA 70125
Phone (504) 891-7731

2103 Gause Blvd E
Slidell, LA 70461
Phone (985) 643-5743

Practitioners & affiliated clinicians

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1285975482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772",
            "address_2": "CREDENTIALING-MC 2295",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950784",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S CLAIBORNE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70125",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINUTECLINIC DIAGNOSTIC OF LOUISIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-13",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.