Organization Active NPI

Culicchia Neurological Clinic, LLC

  • Specialist
  • Marrero, LA
National Provider Identifier
1376669952
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CULICCHIA NEUROLOGICAL CLINIC, LLC
Practice address
1111 Medical Center Blvd.
Ste. S-750
Marrero, LA 70072
Phone
(504) 340-6976
Fax
(504) 349-6775
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Authorized official

Name
Ms. Darla P Adams
Title
Business Office Manager
Phone
(504) 340-6976

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1111 Medical Center Blvd.
Ste. S-750
Marrero, LA 70072

Mailing address

1111 Medical Center Blvd.
Ste. S-750
Marrero, LA 70072
Phone (504) 340-6976

Other identifiers 1

IdentifierTypeStateIssuer
1797626MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040713000267 LA Part B Supplier - Clinic/Group Practice 1850379157 Receives reassigned benefits from 23 practitioners
Practice locations: Marrero, LA; New Orleans, LA

National Provider Directory

National Provider Directory

Locations

1111 Medical Center Blvd
Ste S63
Marrero, LA 70072

1111 Medical Center Blvd
Ste 630
Marrero, LA 70072
Phone (504) 934-8140

1151 Barataria Blvd
Ste 4300
Marrero, LA 70072
Phone (504) 934-8140

1111 Medical Center Blvd
Ste 750
Marrero, LA 70072

1051 Barataria Blvd Ste 4300
Marrero, LA 70072

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1376669952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD.",
            "address_2": "STE. S-750",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-340-6976",
            "fax_number": "504-349-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD.",
            "address_2": "STE. S-750",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-340-6976",
            "fax_number": "504-349-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULICCHIA NEUROLOGICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "DARLA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "504-340-6976",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1797626",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.