St James Parish Hosp Serv Dist
Organization Active NPI Surgery Physician · Lutcher, LA
NPI 1457762056 · NPPES record last updated May 8, 2017
Key facts
- NPI
- 1457762056
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- ST JAMES PARISH HOSP SERV DIST
- Practice address
- 1645 Lutcher Ave
Lutcher, LA 70071-5150 - Phone
- (225) 258-2080
- Fax
- (225) 258-2081
- NPI assigned
- May 16, 2014
- Organization subpart
- No
Authorized official
- Name
- Mary Ellen G Pratt
- Title
- Ceo
- Phone
- (225) 258-5990
Other NPIs on the same Medicare enrollment 6
Practitioners 3
-
Jeanette Ellen Hotard, CFNP
-
Jarelle Morgan Scott, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
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
- ST JAMES SURGICAL SPECIALISTS
Other providers in Lutcher, LA
- Kelly Bourgeois Roussel
- Crystal Ann Rowell
- Rpe,Inc
- Blaze Schifferstein
- Shelika Scott
- St James Parish Hosp Serv Dist
- St James Parish School Board
- St. James Homecare, LLC
- St. James Parish Hosp Serv Dist
- St. James Parish Hosp Serv Dist
All providers in Lutcher, LA · Surgery Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.