TLC Mobile Medical of Lafayette, Inc

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

TLC MOBILE MEDICAL OF LAFAYETTE, INC

Practice address

110 Hugh Wallis Rd
Lafayette, LA 70508-2107

Phone

(337) 289-5456

Fax

(337) 289-0119

NPI assigned

Mar 15, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Brenda S Leblanc

Title

Owner

Phone

(281) 346-0801

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Portable X-ray supplier certification: CCN 19X0009814

Legal name

TLC MOBILE MEDICAL OF LAFAYETTE INC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Sep 4, 1987

Last certification

Oct 4, 2022

Ownership / control type

Corporation

Facility address

110 Hugh Wallis Road
Lafayette, LA 70508

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Albert R Corne Jr., MD

  • Specialist
  • Lafayette, LA
  • NPI 1336183417
  NPD (past)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1326017153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80735",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705980735",
            "telephone_number": "281-346-0801",
            "fax_number": "281-346-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HUGH WALLIS RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705082107",
            "telephone_number": "337-289-5456",
            "fax_number": "337-289-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC MOBILE MEDICAL OF LAFAYETTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "LEBLANC",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-346-0801",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1373605",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "39511",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "630000399",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Chauvin, D.D.S., a.P.D.C.
• Lucille Tisby, CAC
• Emily Victoria Titus, M. O. T
• Simon Peter Tiu, MD
• TJBG Inc
• TMS of Acadiana LLC
• TMS of Louisiana
• Today'S Eyecare, LLC
• Erica Tompkins
• Jasmine Toney

• Mobile Radiology Clinic/Center in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Mobile Radiology Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.