Organization Active NPI

Rolandponarskiatprofessionalcorporation

  • Internal Medicine Physician
  • Monroe, LA
National Provider Identifier
1386803971
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD09892R Issued in MD
Legal business name
ROLANDPONARSKIATPROFESSIONALCORPORATION
Practice address
487 Rowland Dr
Monroe, LA 71203-8545
Phone
(318) 343-6780
NPI assigned
Jun 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Roland Ponarski, MD
Title
Internalmedinicephysician
Phone
(318) 343-6780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MD09892R MD Primary

Addresses

Primary practice location

487 Rowland Dr
Monroe, LA 71203-8545

Mailing address

487 Rowland Dr
Monroe, LA 71203-8545
Phone (318) 343-6780

Other identifiers 1

IdentifierTypeStateIssuer
1967777MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1386803971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "487 ROWLAND DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712038545",
            "telephone_number": "318-343-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 ROWLAND DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712038545",
            "telephone_number": "318-343-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLANDPONARSKIATPROFESSIONALCORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "PONARSKI",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_title_or_position": "INTERNALMEDINICEPHYSICIAN",
        "authorized_official_telephone_number": "318-343-6780",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "MD09892R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1967777",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.