Organization Active NPI

Mga Gastrointestinal Diagnostic & Therapeutic Center

  • Endoscopy Clinic/Center
  • Marrero, LA
National Provider Identifier
1306862941
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
License
60 Issued in LA
Legal business name
MGA GASTROINTESTINAL DIAGNOSTIC & THERAPEUTIC CENTER
Practice address
1111 Medical Center Blvd
S450
Marrero, LA 70072-3151
Phone
(504) 349-6309
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Mr. Christopher A Holden
Title
Chief Manager of LLC
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X 60 LA Primary

Addresses

Primary practice location

1111 Medical Center Blvd
S450
Marrero, LA 70072-3151

Mailing address

PO Box 1187
Marrero, LA 70073-1187
Phone (504) 349-6423

Other identifiers 1

IdentifierTypeStateIssuer
1980714MedicaidLA

Other names 1

  • MGA Gastrointestinal Diagnostic and Therapeutic Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070507000561 LA Part B Supplier - Ambulatory Surgical Center 5890891915 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marrero, LA
O20070509000015 LA Part B Supplier - Ambulatory Surgical Center 5890891915 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Orleans, LA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Mga Gastrointestinal Diagnostic Therapeutic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1306862941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1187",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700731187",
            "telephone_number": "504-349-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "S450",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGA GASTROINTESTINAL DIAGNOSTIC & THERAPEUTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "HOLDEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF MANAGER OF LLC",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "LA",
            "license": "60",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1980714",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MGA Gastrointestinal Diagnostic and Therapeutic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.