Louisiana Dermatology Associates, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LOUISIANA DERMATOLOGY ASSOCIATES, LLC

Practice address

10154 Jefferson Hwy
Baton Rouge, LA 70809-2725

Phone

(225) 490-0812

Fax

(225) 490-0813

NPI assigned

Oct 19, 2005

Last updated

Mar 31, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Glenda M Imes

Title

Practice Manager

Phone

(225) 490-0812

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 13

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.

• Mary Curry Dickerson, M.D.

  • Specialist
  • Baton Rouge, LA
  • NPI 1972543445

  Dermatology

  Medicare reassignment Care Compare group NPD
• Franklin R Johnson Jr., M.D.

  • Dermatology Physician
  • Baton Rouge, LA
  • NPI 1275522328
  Medicare reassignment Care Compare group NPD
• Jennifer Henderson Leblanc, APRN, BC

  • Adult Health Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1033108238
  Medicare reassignment Care Compare group NPD
• Sarah McGinty, M.D.

  • Dermatology Physician
  • Baton Rouge, LA
  • NPI 1164841243
  Medicare reassignment Care Compare group NPD
• Donna Nunnally, MD

  • Dermatology Physician
  • Baton Rouge, LA
  • NPI 1306867080
  Medicare reassignment Care Compare group NPD
• Ira Hughes Thorla Jr., M.D.

  • Dermatology Physician
  • Baton Rouge, LA
  • NPI 1730178047
  Medicare reassignment Care Compare group NPD
• Mark D. Callender, P.A.

  • Physician Assistant
  • Slidell, LA
  • NPI 1942406616
  Medicare reassignment Care Compare group
• Kristen Elizabeth Hebert, PA-C

  • Physician Assistant
  • Zachary, LA
  • NPI 1093268963
  Medicare reassignment Care Compare group
• Tara Lynn Rheubottom, PA

  • Medical Physician Assistant
  • Baton Rouge, LA
  • NPI 1134118466
  Medicare reassignment Care Compare group
• Amy Tycer Smith, PA

  • Physician Assistant
  • Baton Rouge, LA
  • NPI 1336378678
  Medicare reassignment Care Compare group
• Kamryn Alise King, PA-C

  • Physician Assistant
  • Walker, LA
  • NPI 1528899218
  Medicare reassignment
• Kristen Lebleu Losavio, MD

  • Dermatology Physician
  • Baton Rouge, LA
  • NPI 1225203904
  NPD (past)

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238457600000",
    "number": "1326037649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10154 JEFFERSON HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708092725",
            "telephone_number": "225-490-0812",
            "fax_number": "225-490-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10154 JEFFERSON HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708092725",
            "telephone_number": "225-490-0812",
            "fax_number": "225-490-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA DERMATOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2009-03-31",
        "status": "A",
        "authorized_official_last_name": "IMES",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "225-490-0812",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louisiana Department of Health - Office of Public Health
• Louisiana Department of Health - Office of Public Health
• Louisiana Department of Health and Hospitals
• Louisiana Department of Health/Office for Citizens With Developmental Disabilities
• Louisiana Dept. of Health and Hospital (Office of Public Health Genetics)
• Louisiana Ear, Nose, Throat & Sinus, LLC
• Louisiana Edoscopy Center, Inc.
• Louisiana Emergency & Trauma Specialists
• Louisiana Empowerment Services
• Louisiana Empowerment Services

• Dermatology Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.