Renal Associates of Baton Rouge, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

RENAL ASSOCIATES OF BATON ROUGE, LLC

Practice address

5131 Odonovan Dr Ste 100
Baton Rouge, LA 70808-4791

Phone

(225) 767-4893

Fax

(225) 767-5494

NPI assigned

Oct 27, 2006

Last updated

Jun 29, 2022By 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

Mary Alice Stanford

Title

Executive Director

Phone

(225) 767-4893

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Baton Rouge Vascular Access ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Baton Rouge, LA
  • NPI 1023542339

  Member Of

  NPD member
• Baton Rouge Vascular Access LLC

  • Vascular & Interventional Radiology Physician
  • Baton Rouge, LA
  • NPI 1669753893

  Member Of

  NPD member

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Nephrology Management LLC

  • Nephrology Physician
  • Baton Rouge, LA
  • NPI 1558815720
  NPPES parent name

Practitioners 34

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.

• Teicha Alexis, FNP

  • Family Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1841958105
  Medicare reassignment Care Compare group NPD
• Mahesh Reddy Basireddy, MD

  • Nephrology Physician
  • Baton Rouge, LA
  • NPI 1578777058
  Medicare reassignment Care Compare group NPD
• Emily Cecile Burke, AGACNP

  • Acute Care Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1902311053
  Medicare reassignment Care Compare group NPD
• Raynold James Corona, MD

  • Nephrology Physician
  • Baton Rouge, LA
  • NPI 1790782068
  Medicare reassignment Care Compare group NPD
• Rachel Fontenot Gray, FNP-C

  • Family Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1992043525
  Medicare reassignment Care Compare group NPD
• Dawn Hebert, FNP

  • Family Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1043553993
  Medicare reassignment Care Compare group NPD
• Mitchell J Hebert, MD

  • Nephrology Physician
  • Baton Rouge, LA
  • NPI 1861499154
  Medicare reassignment Care Compare group NPD
• Damodar Reddy Kumbala, M.D.

  • Nephrology Physician
  • Baton Rouge, LA
  • NPI 1922188390
  Medicare reassignment Care Compare group NPD
• Victoria M Labatut, MSN, FNP-C

  • Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1992376834
  Medicare reassignment Care Compare group NPD
• Robert P Landry, MD

  • Nephrology Physician
  • Baton Rouge, LA
  • NPI 1841297124
  Medicare reassignment Care Compare group NPD
• Natasha Fisher Lewis, FNP

  • Family Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1639503550
  Medicare reassignment Care Compare group NPD
• Christopher Peter Luscy, MD

  • Nephrology Physician
  • Baton Rouge, LA
  • NPI 1255338521
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1366528135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5131 ODONOVAN DR STE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084791",
            "telephone_number": "225-767-4893",
            "fax_number": "225-767-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5131 ODONOVAN DR STE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084791",
            "telephone_number": "225-767-4893",
            "fax_number": "225-767-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL ASSOCIATES OF BATON ROUGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "STANFORD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ALICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "225-767-4893"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1796174",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Lee Rembert, BSN
• Remendium Labs LLC
• Reminiscence Home Care Services, LLC
• Reminiscence Home Care Services, LLC
• Renaissance Healthcare, LLC
• Renal Life Link Inc (Baton Rouge Renal Center)
• Tessa D Renaud, NP
• Diara Reneau
• Renewal Counseling and Wellness Center, LLC
• Renewed Life Solutions, LLC

• Specialist in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.