St. Charles Medical Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ST. CHARLES MEDICAL CLINIC

Practice address

1057 Paul Maillard Rd
Suite 240
Luling, LA 70070-4349

Phone

(985) 785-2045

NPI assigned

Sep 28, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chemmale JayakrishnanNPI 1376635607

Title

President/Doctor

Phone

(985) 785-2045

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Chemmale Jayakrishnan

  • Specialist
  • Luling, LA
  • NPI 1376635607
  NPD (past) Authorized official

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1407947708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25",
            "city": "LULING",
            "state": "LA",
            "postal_code": "700700025",
            "telephone_number": "985-785-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 PAUL MAILLARD RD",
            "address_2": "SUITE 240",
            "city": "LULING",
            "state": "LA",
            "postal_code": "700704349",
            "telephone_number": "985-785-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CHARLES MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JAYAKRISHNAN",
        "authorized_official_first_name": "CHEMMALE",
        "authorized_official_title_or_position": "PRESIDENT/DOCTOR",
        "authorized_official_telephone_number": "985-785-2045",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1792292",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St Charles Parish Hospital (St Charles Parish Hospital Medical Staff)
• St Charles Parish Hospital
• St Charles Parish Hospital
• St Charles Parish Hospital
• St Charles Parish Hospital
• St. Charles Parish Hospital
• St. Charles Parish School Board
• St. Charles Parish School Board
• Charlene B Stamps, CRNA
• Patrize Stuart

• Primary Care Clinic/Center in Luling, LA
• Providers in Luling, LA by specialty
• Primary Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.