Organization Active NPI

St James Parish Hosp Serv Dist

Doing business as St James Surgical Specialists

  • Surgery Physician
  • Lutcher, LA
National Provider Identifier
1457762056
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ST JAMES PARISH HOSP SERV DIST
Doing business as
St James Surgical Specialists
Practice address
1645 Lutcher Ave
Lutcher, LA 70071-5150
Phone
(225) 258-2080
Fax
(225) 258-2081
NPI assigned
May 16, 2014
Last updated
May 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Authorized official

Name
Mary Ellen G Pratt
Title
Ceo
Phone
(225) 258-5990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1645 Lutcher Ave
Lutcher, LA 70071-5150

Mailing address

1645 Lutcher Ave
Lutcher, LA 70071-5150
Phone (225) 258-2080

Other names 1

  • ST JAMES SURGICAL SPECIALISTS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000748 LA Part B Supplier - Clinic/Group Practice 3476459850 Receives reassigned benefits from 13 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lutcher, LA; Vacherie, LA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1645 Lutcher Ave
Lutcher, LA 70071
Phone (225) 258-5901

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1457762056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 LUTCHER AVE",
            "city": "LUTCHER",
            "state": "LA",
            "postal_code": "700715150",
            "telephone_number": "225-258-2080",
            "fax_number": "225-258-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 LUTCHER AVE",
            "city": "LUTCHER",
            "state": "LA",
            "postal_code": "700715150",
            "telephone_number": "225-258-2080",
            "fax_number": "225-258-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JAMES PARISH HOSP SERV DIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-16",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "MARY ELLEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-258-5990"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST JAMES SURGICAL SPECIALISTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lutcher, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.