Organization Active NPI

Louisiana Urology Center

  • Urology Physician
  • Lafayette, LA
National Provider Identifier
1306021357
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
11767R Issued in LA
Legal business name
LOUISIANA UROLOGY CENTER
Practice address
5000 Ambassador Caffery Pkwy
BLD 16
Lafayette, LA 70508-6984
Phone
(337) 406-8009
Fax
(337) 406-8010
NPI assigned
Jan 8, 2008
Last updated
Sep 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Authorized official

Name
Dr. Thomas J Forest, M.D.,NPI 1760489637
Title
Physician
Phone
(337) 406-8009

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 11767R LA Primary

Addresses

Primary practice location

5000 Ambassador Caffery Pkwy
BLD 16
Lafayette, LA 70508-6984

Mailing address

5000 Ambassador Caffery Pkwy
BLD 16
Lafayette, LA 70508-6984
Phone (337) 406-8009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080129000102 LA Part B Supplier - Clinic/Group Practice 8729160817 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, LA

National Provider Directory

National Provider Directory

Locations

5000 Ambassador Caffery Pkwy
Bldg 16
Lafayette, LA 70508
Phone (337) 406-8009

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1306021357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 AMBASSADOR CAFFERY PKWY",
            "address_2": "BLD 16",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086984",
            "telephone_number": "337-406-8009",
            "fax_number": "337-406-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 AMBASSADOR CAFFERY PKWY",
            "address_2": "BLD 16",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086984",
            "telephone_number": "337-406-8009",
            "fax_number": "337-406-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA UROLOGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "FOREST",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "337-406-8009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "LA",
            "license": "11767R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.