St. Marys Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

19D1048935 Issued in LA

Legal business name

ST. MARYS LABORATORY

Practice address

311 S Pine St
Deridder, LA 70634-4837

Phone

(337) 463-3500

Fax

(337) 463-3526

NPI assigned

Dec 6, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Ernesto Antonio Kufoy, MDNPI 1295792596

Title

President

Phone

(337) 463-3500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• kufoy medical clinic Doing business as

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

CLIA laboratory certificates

Tax ID family

Kufoy Medical Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Kufoy Medical Clinic

  • Sleep Disorder Diagnostic Clinic/Center
  • Deridder, LA
  • NPI 1306086616
  NPD tax ID
• Kufoy Medical Clinic

  • Internal Medicine Physician
  • Deridder, LA
  • NPI 1417118084
  NPD tax ID

Practitioners 1

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

• Ernesto A Kufoy, M.D

  • Specialist
  • Deridder, LA
  • NPI 1295792596
  NPD (past) Authorized official

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1386947844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344837",
            "telephone_number": "337-463-3500",
            "fax_number": "337-463-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344837",
            "telephone_number": "337-463-3500",
            "fax_number": "337-463-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARYS LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "KUFOY",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-463-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "LA",
            "license": "19D1048935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1666866",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "kufoy medical clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• April Solea, CNM
• Jonathon Sossamon
• Wendy Spinden, MA, LPC
• Jasmine Kay Sprauer
• St. Joseph'S Medical Equipment, LLC
• Lynsey Jean Stambaugh
• Star Consulting Services, Inc.
• Stay at Home
• Laura Annette Stelly, RLT
• Step One Counseling and Consulting, LLC

• Clinical Medical Laboratory in Deridder, LA
• Providers in Deridder, LA by specialty
• Clinical Medical Laboratory in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.