NPIMap

Organization Active NPI

Primary Care at Home of Louisiana IV, LLC

Doing business as Primary Care at Home of Kenner

  • Family Nurse Practitioner
  • Kenner, LA
National Provider Identifier
1437664943
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PRIMARY CARE AT HOME OF LOUISIANA IV, LLC
Doing business as
Primary Care at Home of Kenner
Practice address
200 W Esplanade Ave Ste 601
Kenner, LA 70065-2475
Phone
(504) 252-3305
Fax
(504) 208-3249
NPI assigned
Dec 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Authorized official

Name
Donald D. Stelly
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

200 W Esplanade Ave Ste 601
Kenner, LA 70065-2475

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other names 1

  • Primary Care at Home of Kenner Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1437664943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ESPLANADE AVE STE 601",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652475",
            "telephone_number": "504-252-3305",
            "fax_number": "504-208-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE AT HOME OF LOUISIANA IV, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A",
        "authorized_official_last_name": "STELLY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care at Home of Kenner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenner, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.