NPIMap

Organization Active NPI

St. James Primary Care, Apmc

  • General Practice Physician
  • Gramercy, LA
National Provider Identifier
1346429453
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
1444111 Issued in LA
Legal business name
ST. JAMES PRIMARY CARE, APMC
Practice address
827 N Pine St
Gramercy, LA 70052-3659
Phone
(225) 869-9200
NPI assigned
Oct 25, 2007
Last updated
Jun 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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

Authorized official

Name
Dr. Anu Prasad Vellanki, MDNPI 1497746499
Title
Doctor
Phone
(225) 869-9200

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 1444111 LA Primary

Addresses

Primary practice location

827 N Pine St
Gramercy, LA 70052-3659

Mailing address

PO Box 419
Gramercy, LA 70052-0419
Phone (225) 869-9200

Other identifiers 1

IdentifierTypeStateIssuer
057843586AOtherLABLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040728000368 LA Part B Supplier - Clinic/Group Practice 0941270961 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
Practice locations: Gramercy, LA
O20100324001059 LA Part B Supplier - Clinic/Group Practice 0941270961 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Gramercy, LA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309305600000",
    "number": "1346429453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "city": "GRAMERCY",
            "state": "LA",
            "postal_code": "700520419",
            "telephone_number": "225-869-9200",
            "fax_number": "225-869-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 N PINE ST",
            "city": "GRAMERCY",
            "state": "LA",
            "postal_code": "700523659",
            "telephone_number": "225-869-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JAMES PRIMARY CARE, APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2011-06-29",
        "status": "A",
        "authorized_official_last_name": "VELLANKI",
        "authorized_official_first_name": "ANU",
        "authorized_official_middle_name": "PRASAD",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "225-869-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "1444111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "057843586A",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gramercy, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.