Scott G Petrie MD Apmc

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

SCOTT G PETRIE MD APMC

Doing business as

Orthopaedic & Sports Clinic

Practice address

1014 West St Clare Boulevard
Ste 1020
Gonzales, LA 70737

Phone

(225) 743-2008

Fax

(225) 743-2010

NPI assigned

Sep 15, 2020

Organization subpart

No

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

Authorized official

Name

Mackenzie Hahn

Title

Ncpdp Coordinator

Phone

(888) 590-0808

Specialties & licenses 1

Addresses

Other names 1

• Orthopaedic & Sports Clinic Doing business as

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1407461593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 RITTENHOUSE CIRCLE",
            "address_2": "EAST BUILDING STE 5",
            "city": "BRISTOL",
            "state": "PA",
            "postal_code": "19007",
            "telephone_number": "888-590-0808",
            "fax_number": "267-573-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 WEST ST CLARE BOULEVARD",
            "address_2": "STE 1020",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "70737",
            "telephone_number": "225-743-2008",
            "fax_number": "225-743-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT G PETRIE MD APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "MACKENZIE",
        "authorized_official_title_or_position": "NCPDP COORDINATOR",
        "authorized_official_telephone_number": "888-590-0808"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthopaedic & Sports Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Billie Jo Savoy
• Alexandra Averil Scarbrough
• Tiffany Fontenot Schexnayder, CCC-A
• William Ryan Schuette
• Lisa Schuster
• Melissa Scott
• Shelby Manuel Segalla, DDS
• David Henry Sepulveda, PA-C
• Tanya Seward, NP
• Rahil Devendra Shah, M.D.

• Non-Pharmacy Dispensing Site in Gonzales, LA
• Providers in Gonzales, LA by specialty
• Non-Pharmacy Dispensing Site in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.