NPIMap

Organization Active NPI

Ibl Special Care Management Services

  • Exclusive Provider Organization
  • Baton Rouge, LA
National Provider Identifier
1306083894
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
PCA 15172 Issued in LA
Legal business name
IBL SPECIAL CARE MANAGEMENT SERVICES
Practice address
11616 Southfork Ave
Ste 204
Baton Rouge, LA 70816-5241
Phone
(225) 291-3123
Fax
(225) 291-3069
NPI assigned
Jan 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Authorized official

Name
Ms. Samantha Ann Roach
Title
Administrator
Phone
(225) 291-3123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X PCA 15172 LA Primary

Addresses

Primary practice location

11616 Southfork Ave
Ste 204
Baton Rouge, LA 70816-5241

Mailing address

14241 Coursey Blvd
Ste A12167
Baton Rouge, LA 70817-1368
Phone (225) 291-3123

Other identifiers 1

IdentifierTypeStateIssuer
PC0007839MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Ibl Special Care Management Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233705600000",
    "number": "1306083894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14241 COURSEY BLVD",
            "address_2": "STE A12167",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708171368",
            "telephone_number": "225-291-3123",
            "fax_number": "225-291-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11616 SOUTHFORK AVE",
            "address_2": "STE 204",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708165241",
            "telephone_number": "225-291-3123",
            "fax_number": "225-291-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBL SPECIAL CARE MANAGEMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-02-04",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "225-291-3123",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "LA",
            "license": "PCA 15172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC0007839",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.