Individual provider Active NPI

Paul Abide, MD

  • General Practice Physician
  • Denham Springs, LA
National Provider Identifier
1376544106
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16898 Issued in LA
Practice address
1585 S Range Ave
Denham Springs, LA 70726-5201
Phone
(225) 791-0002
Fax
(225) 791-0228
NPI assigned
Aug 2, 2005
Last updated
Aug 31, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16898 LA Primary

Addresses

Primary practice location

1585 S Range Ave
Denham Springs, LA 70726-5201

Mailing address

Dept 960139
Oklahoma City, OK 73196-0001
Phone (877) 485-4474

Other identifiers 1

IdentifierTypeStateIssuer
1355658MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180828000338 MS Practitioner - Family Practice 1557571767 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16898LAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Medical Group CurrentSince May 12, 2018 Accepting new patients
Delta Physician Practices Past Accepting new patients

Locations

1693 Fairgrounds Rd
Greenville, MS 38703
Phone (662) 378-3783

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1376544106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 960139",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731960001",
            "telephone_number": "877-485-4474",
            "fax_number": "405-844-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 S RANGE AVE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707265201",
            "telephone_number": "225-791-0002",
            "fax_number": "225-791-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABIDE",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "16898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1355658",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denham Springs, LA

Sources for this page

Verify at the official NPI Registry.