Organization Active NPI

Louisiana Mohs & Skin Surgery Center, LLC

  • MOHS-Micrographic Surgery Physician
  • Monroe, LA
National Provider Identifier
1295448603
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
LOUISIANA MOHS & SKIN SURGERY CENTER, LLC
Practice address
2408 Duval Dr
Monroe, LA 71201-2986
Phone
(318) 516-2611
Fax
(318) 516-2711
NPI assigned
Dec 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Authorized official

Name
Dr. Caitlin Robinson, MDNPI 1568872141
Title
Owner
Phone
(318) 547-8055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0101X Primary
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

2408 Duval Dr
Monroe, LA 71201-2986

Mailing address

2408 Duval Dr
Monroe, LA 71201-2986
Phone (318) 516-2611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230113001524 LA Part B Supplier - Clinic/Group Practice 4183095912 Receives reassigned benefits from 3 practitioners
Practice locations: Monroe, LA
O20260122001361 LA DME Supplier - Physician - Dermatology 4183095912 Practice locations: Monroe, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2281727Louisiana Mohs & Skin Surgery Center, LLC2408 Duval Drive, Monroe, LA 71201ComplianceSep 12, 2027

National Provider Directory

National Provider Directory

Locations

2408 Duval Dr
Monroe, LA 71201
Phone (318) 516-2611

Practitioners & affiliated clinicians

Practitioners 3

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": "1672358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1295448603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 DUVAL DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012986",
            "telephone_number": "318-516-2611",
            "fax_number": "318-516-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 DUVAL DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012986",
            "telephone_number": "318-516-2611",
            "fax_number": "318-516-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA MOHS & SKIN SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-30",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "CAITLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-547-8055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.