North Shore Heart and Vascular, L.L.C.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

NORTH SHORE HEART AND VASCULAR, L.L.C.

Practice address

675 N Causeway Blvd
Mandeville, LA 70448-4600

Phone

(985) 200-3530

Fax

(985) 202-2010

NPI assigned

Jun 9, 2016

Last updated

Jun 9, 2016By 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

Dr. Bruce M EnnisNPI 1639134901

Title

M.D.

Phone

(985) 200-3530

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

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

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13800/brand/1/csg/1/fhir/r4

Practitioners 4

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.

• Bruce Martin Ennis, M.D.

  • Interventional Cardiology Physician
  • Mandeville, LA
  • NPI 1639134901

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD Authorized official
• Amanda R Lavigne, APRN, FNP-C

  • Family Nurse Practitioner
  • Covington, LA
  • NPI 1386306538
  Medicare reassignment Care Compare group NPD
• Jean Genzale, NP

  • Adult Health Nurse Practitioner
  • Hammond, LA
  • NPI 1972743243
  Medicare reassignment NPD
• Gina Marie Mixon, FNP-C

  • Family Nurse Practitioner
  • Hammond, LA
  • NPI 1558712570
  Medicare reassignment NPD

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1376992362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N CAUSEWAY BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704484600",
            "telephone_number": "985-200-3530",
            "fax_number": "985-202-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N CAUSEWAY BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704484600",
            "telephone_number": "985-200-3530",
            "fax_number": "985-202-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE HEART AND VASCULAR, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "ENNIS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "985-200-3530",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Cardiology Physician in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Interventional Cardiology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.