NPIMap

Organization Active NPI

Juan J Perez Ruiz M.D. a Professional Medical Corporation

  • Clinic/Center
  • Lafayette, LA
National Provider Identifier
1457501686
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
022070 Issued in LA
Legal business name
JUAN J PEREZ RUIZ M.D. A PROFESSIONAL MEDICAL CORPORATION
Practice address
461 Heymann Blvd
Lafayette, LA 70503-2616
Phone
(337) 289-8717
Fax
(337) 289-8718
NPI assigned
Sep 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2013

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

Authorized official

Name
Juan Jose Perez Ruiz, M.D.
Title
Owner
Phone
(337) 289-8717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 022070 LA Primary

Addresses

Primary practice location

461 Heymann Blvd
Lafayette, LA 70503-2616

Mailing address

461 Heymann Blvd
Lafayette, LA 70503-2616
Phone (337) 289-8717

Other identifiers 2

IdentifierTypeStateIssuer
1821106261OtherNPI INDIVIDUAL
1492558MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Juan J Perez Ruiz MD a Professional Medical Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367884800000",
    "number": "1457501686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 HEYMANN BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032616",
            "telephone_number": "337-289-8717",
            "fax_number": "337-289-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 HEYMANN BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032616",
            "telephone_number": "337-289-8717",
            "fax_number": "337-289-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN J PEREZ RUIZ M.D. A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2013-05-07",
        "status": "A",
        "authorized_official_last_name": "PEREZ RUIZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-289-8717",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "LA",
            "license": "022070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1821106261",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1492558",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; 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.