NPIMap

Organization Active NPI

Advanced Videoscopic Surgery of Baton Rouge

  • Surgery Physician
  • Baton Rouge, LA
National Provider Identifier
1336170257
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
11666R Issued in LA
Legal business name
ADVANCED VIDEOSCOPIC SURGERY OF BATON ROUGE
Practice address
9094 Perkins Road
Suite a
Baton Rouge, LA 70810
Phone
(225) 819-0983
Fax
(225) 819-0986
NPI assigned
Jul 6, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Drake Eric Bellanger, MDNPI 1659302586
Title
Owner
Phone
(225) 819-0983

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 11666R LA Primary
Surgery Physician 208600000X 00017405 AL

Addresses

Primary practice location

9094 Perkins Road
Suite a
Baton Rouge, LA 70810

Mailing address

9094 Perkins Road
Suite a
Baton Rouge, LA 70810
Phone (225) 819-0983

Other identifiers 1

IdentifierTypeStateIssuer
1697486MedicaidLA

National Provider Directory

National Provider Directory

Locations

9094 Perkins Rd
Ste A
Baton Rouge, LA 70810
Phone (225) 819-0983

Practitioners & affiliated clinicians

Practitioners 2

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": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336170257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9094 PERKINS ROAD",
            "address_2": "SUITE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70810",
            "telephone_number": "225-819-0983",
            "fax_number": "225-819-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9094 PERKINS ROAD",
            "address_2": "SUITE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70810",
            "telephone_number": "225-819-0983",
            "fax_number": "225-819-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VIDEOSCOPIC SURGERY OF BATON ROUGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BELLANGER",
        "authorized_official_first_name": "DRAKE",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-819-0983",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "11666R",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "00017405",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1697486",
            "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 Aug 22, 2020; 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.