NPIMap

Organization Active NPI

Southern Urology LLC

Doing business as Southern Urology LaHaye

  • Urology Physician
  • Ville Platte, LA
National Provider Identifier
1346471174
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
020487 Issued in LA
Legal business name
SOUTHERN UROLOGY LLC
Doing business as
Southern Urology LaHaye
Practice address
4940 Vidrine Rd
Ville Platte, LA 70586-8780
Phone
(337) 506-3540
Fax
(337) 506-3541
NPI assigned
Jul 28, 2009
Last updated
Apr 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Marcellus E Lahaye, MDNPI 1073584744
Title
MD
Phone
(337) 506-3540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 020487 LA Primary

Addresses

Primary practice location

4940 Vidrine Rd
Ville Platte, LA 70586-8780

Mailing address

PO Box 54028
Lafayette, LA 70505-4028
Phone (337) 506-3540

Other identifiers 2

IdentifierTypeStateIssuer
1305308MedicaidLA
5DF66OtherLAMEDICARE

Other names 1

  • Southern Urology LaHaye Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930023644 LA DME Supplier - Physician - Urology 5597833772 Practice locations: Ville Platte, LA

Other NPIs with the same Medicare PAC ID 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1095159Southern Urology LLC4940 Vidrine Road, Ville Platte, LA 70586Provider-performed microscopyFeb 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Southern Urology LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4940 Vidrine Rd
Ville Platte, LA 70586
Phone (337) 222-2515

Practitioners & affiliated clinicians

Practitioners 1

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": "1248739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1346471174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54028",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705054028",
            "telephone_number": "337-506-3540",
            "fax_number": "337-506-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 VIDRINE RD",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705868780",
            "telephone_number": "337-506-3540",
            "fax_number": "337-506-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN UROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-28",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "LAHAYE",
        "authorized_official_first_name": "MARCELLUS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "337-506-3540",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "LA",
            "license": "020487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1305308",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "5DF66",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Southern Urology LaHaye",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ville Platte, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.