Active NPI
Rolandponarskiatprofessionalcorporation
- Internal Medicine Physician
- Monroe, LA
National Provider Identifier
1386803971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD09892R
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1967777 | Medicaid | LA |
National Provider Directory
National Provider DirectoryNPI 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.