NPIMap

Organization Active NPI

Northshore Family Med. Ctr

  • Family Medicine Physician
  • Slidell, LA
National Provider Identifier
1467408799
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHSHORE FAMILY MED. CTR
Practice address
1150 Robert Blvd
#100
Slidell, LA 70458
Phone
(985) 646-1122
Fax
(985) 646-1315
NPI assigned
May 26, 2006
Last updated
Feb 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Authorized official

Name
Kim Casey
Title
Business Administrator
Phone
(985) 646-1122

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Family Medicine Physician 207Q00000X LA

Addresses

Primary practice location

1150 Robert Blvd
#100
Slidell, LA 70458

Mailing address

1150 Robert Blvd
#100
Slidell, LA 70458
Phone (985) 646-1122

Other identifiers 3

IdentifierTypeStateIssuer
CT0105OtherLARAILROAD MEDICARE
1798622MedicaidLA
36092OtherLABLUE CROSS

National Provider Directory

National Provider Directory

Locations

1150 Robert Blvd
Ste 100
Slidell, LA 70458
Phone (985) 646-1122

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1467408799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 ROBERT BLVD",
            "address_2": "#100",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "70458",
            "telephone_number": "985-646-1122",
            "fax_number": "985-646-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 ROBERT BLVD",
            "address_2": "#100",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "70458",
            "telephone_number": "985-646-1122",
            "fax_number": "985-646-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE FAMILY MED. CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "985-646-1122"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CT0105",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1798622",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "36092",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.