Organization Active NPI

Metairie Institute Comprehensive Health, LLC

  • Specialist
  • Mandeville, LA
National Provider Identifier
1396924536
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
METAIRIE INSTITUTE COMPREHENSIVE HEALTH, LLC
Practice address
231 Saint Ann Dr
Ste 2
Mandeville, LA 70471-3219
Phone
(985) 624-5410
Fax
(985) 624-5490
NPI assigned
Oct 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Shelli Sutherlin
Title
Billing Manager
Phone
(985) 327-3044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

231 Saint Ann Dr
Ste 2
Mandeville, LA 70471-3219

Mailing address

231 Saint Ann Dr
Ste 2
Mandeville, LA 70471-3219
Phone (985) 624-5410

Other identifiers 1

IdentifierTypeStateIssuer
1119156MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040527000827 LA Part B Supplier - Clinic/Group Practice 1759362486 Receives reassigned benefits from 1 practitioner
Practice locations: Mandeville, LA

National Provider Directory

National Provider Directory

Locations

1129 S Tyler St
Covington, LA 70433
Phone (985) 871-5420

231 Saint Ann Dr
Ste 2
Mandeville, LA 70471
Phone (985) 624-5410

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1396924536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 SAINT ANN DR",
            "address_2": "STE 2",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713219",
            "telephone_number": "985-624-5410",
            "fax_number": "985-624-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 SAINT ANN DR",
            "address_2": "STE 2",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713219",
            "telephone_number": "985-624-5410",
            "fax_number": "985-624-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAIRIE INSTITUTE COMPREHENSIVE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "SUTHERLIN",
        "authorized_official_first_name": "SHELLI",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "985-327-3044"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1119156",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.