Active NPI
Mylaurel Medical Group la, LLC
- General Practice Physician
- New Orleans, LA
National Provider Identifier
1306341060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- MYLAUREL MEDICAL GROUP LA, LLC
- Practice address
- 1320 Magazine St Ste 203
New Orleans, LA 70130-4267 - Phone
- (504) 475-1283
- NPI assigned
- Mar 26, 2018
- Last updated
- Jan 9, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Leslie Baldridge
- Title
- Credentialing
- Phone
- (702) 417-6255
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
1320 Magazine St Ste 203
New Orleans, LA 70130-4267
Mailing address
885 3Rd Ave FL 29
New York, NY 10022-4834
Phone (702) 417-6255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
824 Elmwood Park Blvd
Ste 135
New Orleans, LA 70123
Phone (504) 266-2576
Practitioners & affiliated clinicians
Practitioners 25
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": "1522022400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1704758400000",
"number": "1306341060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "885 3RD AVE FL 29",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100224834",
"telephone_number": "702-417-6255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 MAGAZINE ST STE 203",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701304267",
"telephone_number": "504-475-1283"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MYLAUREL MEDICAL GROUP LA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-03-26",
"last_updated": "2024-01-09",
"certification_date": "2024-01-09",
"status": "A",
"authorized_official_last_name": "BALDRIDGE",
"authorized_official_first_name": "LESLIE",
"authorized_official_title_or_position": "CREDENTIALING",
"authorized_official_telephone_number": "702-417-6255"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"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 Jan 9, 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.