Enclave Health Plus LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ENCLAVE HEALTH PLUS LLC

Practice address

327 Jefferson Oaks Dr
Ruston, LA 71270-7080

Phone

(318) 254-3001

NPI assigned

Jun 11, 2020

Organization subpart

No

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

Authorized official

Name

Sedo Tamakloe, MDNPI 1386652006

Title

MD (Owner)

Phone

(318) 254-3001

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sedo Tamakloe, MD

  • Internal Medicine Physician
  • Ruston, LA
  • NPI 1386652006
  Medicare reassignment Authorized official
• Martina Abena Tamakloe, MD

  • Internal Medicine Physician
  • Ruston, LA
  • NPI 1396770566
  Medicare reassignment

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1477178804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 JEFFERSON OAKS DR",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712707080",
            "telephone_number": "318-254-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 JEFFERSON OAKS DR",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712707080",
            "telephone_number": "318-254-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCLAVE HEALTH PLUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "TAMAKLOE",
        "authorized_official_first_name": "SEDO",
        "authorized_official_title_or_position": "MD (OWNER)",
        "authorized_official_telephone_number": "318-254-3001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Ruston, LA
• Providers in Ruston, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.