NRMC Physician Ipa Inc
Organization Active NPI Surgery Physician · Natchitoches, LA
NPI 1497283733 · NPPES record last updated Jun 26, 2020
Key facts
- NPI
- 1497283733
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- NRMC PHYSICIAN IPA INC
- Practice address
- 601 Keyser Ave
Natchitoches, LA 71457-6020 - Phone
- (318) 214-5770
- Fax
- (318) 214-4625
- NPI assigned
- May 31, 2017
- Organization subpart
- No
Authorized official
- Name
- William B McCormick
- Title
- Cfo
- Phone
- (318) 214-4350
Other NPIs on the same Medicare enrollment 7
Subparts reporting this organization as parent 9
Corporate family (same tax ID) 4
Practitioners 46
-
Furqan Akhtar, MD
-
Mallie Anderson, NP
-
Afsana Asharaf, MD
-
Keith M Ashby, MD
-
Martin Aviles, M.D.
-
Willliam A Ball Jr., M.D.
-
Dana Bennett, APRN
-
Warren C Botnick, M.D.
-
David Maurice Chambers, M.D.
-
Charli Cox, APRN
-
Robert C. Holladay, M.D.
-
Steven Michael Jackson, D.O.
-
Theodore Knatt Sr., M.D.
-
Prathik Krishnan, M.D.
-
Shreedhar Kulkarni, M.D.
-
Phyllis Lynnette Mason, M.D.
-
Moshood Olatinwo, MD
-
Tana Penrod, NP
-
Kenneth L Perego, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170808001651 | LA | Part B Supplier - Clinic/Group Practice | 9234400300 |
Receives reassigned benefits from 44 practitioners 7 other NPIs on this enrollment Practice locations: Natchitoches, LA |
National Provider Directory
- Tax ID family
- NRMC Physician Ipa Inc
Locations
6633 Forest Ave
Ste 205
New Port Richey, FL 34653
Phone (727) 375-2849
301 4th St
#3G
Alexandria, LA 71301
301 4th St
Fl Ter
Alexandria, LA 71301
301 4th St
Ste 3G
Alexandria, LA 71301
601 Keyser Ave
Ste D
Natchitoches, LA 71457
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes | ||
| Hospitalist Physician |
208M00000X |
Addresses
Primary practice location
601 Keyser Ave
Natchitoches, LA 71457-6020
Mailing address
PO Box 2475
Natchitoches, LA 71457-2475
Phone (318) 214-5770
Other practice location 1
740 Keyser Ave Ste D
Natchitoches, LA 71457-6083
Phone (318) 354-2555
Other practice location 2
501 Keyser Ave
Natchitoches, LA 71457-6018
Phone (318) 214-4401
Other names
- NRMC General Surgery Associates
Other providers in Natchitoches, LA
- NRMC Pharmacy Alliance LLC
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
All providers in Natchitoches, 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 Jun 26, 2020. 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.