NPIMap

Organization Active NPI

Dr Jonathan J Gisclair Apmc Dba Lafourche Podiatry Clinic

Doing business as Lafourche Podiatry Clinic

  • Foot Surgery Podiatrist
  • Cut Off, LA
National Provider Identifier
1386832822
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
PD0110 Issued in LA
Legal business name
DR JONATHAN J GISCLAIR APMC DBA LAFOURCHE PODIATRY CLINIC
Doing business as
Lafourche Podiatry Clinic
Practice address
16148 W Main St
Cut Off, LA 70345-3511
Phone
(985) 325-3668
Fax
(985) 325-3670
NPI assigned
Oct 10, 2007
Last updated
Jan 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Authorized official

Name
Dr. Jonathan James Gisclair, DPMNPI 1922020775
Title
President
Phone
(985) 325-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X PD0110 LA Primary

Addresses

Primary practice location

16148 W Main St
Cut Off, LA 70345-3511

Mailing address

PO Box 1759
Department 952
Houston, TX 77251-1759
Phone (713) 554-5304

Other identifiers 1

IdentifierTypeStateIssuer
1131211MedicaidLA

Other names 1

  • Lafourche Podiatry Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

16148 W Main St
Cut Off, LA 70345
Phone (985) 325-3668

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231977600000",
    "number": "1386832822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1759",
            "address_2": "DEPARTMENT 952",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772511759",
            "telephone_number": "713-554-5304",
            "fax_number": "713-554-5324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16148 W MAIN ST",
            "city": "CUT OFF",
            "state": "LA",
            "postal_code": "703453511",
            "telephone_number": "985-325-3668",
            "fax_number": "985-325-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JONATHAN J GISCLAIR APMC DBA LAFOURCHE PODIATRY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2009-01-15",
        "status": "A",
        "authorized_official_last_name": "GISCLAIR",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-325-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "LA",
            "license": "PD0110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1131211",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lafourche Podiatry Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cut Off, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; 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.