NPIMap

Organization Active NPI

Hospital Service District 1 of East Baton Rouge Parish

Doing business as Lane Regional Medical Center-Lane Pediatrics Clinic

  • Pediatrics Physician
  • Zachary, LA
National Provider Identifier
1508380197
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH
Doing business as
Lane Regional Medical Center-Lane Pediatrics Clinic
Practice address
6110 Main St Ste B
Zachary, LA 70791-4079
Phone
(225) 654-3607
Fax
(225) 658-2262
NPI assigned
Jul 26, 2017
Last updated
Mar 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Authorized official

Name
Frank A Corcoran
Title
Chief Executive Officer
Phone
(225) 658-4303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

6110 Main St Ste B
Zachary, LA 70791-4079

Mailing address

6300 Main St
Zachary, LA 70791-4037
Phone (225) 570-2489

Other identifiers 1

IdentifierTypeStateIssuer
1445126MedicaidLA

Other names 1

  • LANE REGIONAL MEDICAL CENTER-LANE PEDIATRICS CLINIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322000429 LA Part B Supplier - Clinic/Group Practice 0941191902 Receives reassigned benefits from 76 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Zachary, LA

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Hospital Service District 121 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

2335 Church St
Ste E
Zachary, LA 70791
Phone (225) 570-2489

Practitioners & affiliated clinicians

Practitioners 5

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": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1508380197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 MAIN ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914037",
            "telephone_number": "225-570-2489",
            "fax_number": "225-570-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 MAIN ST STE B",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914079",
            "telephone_number": "225-654-3607",
            "fax_number": "225-658-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-26",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "CORCORAN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "225-658-4303"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1445126",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LANE REGIONAL MEDICAL CENTER-LANE PEDIATRICS CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Zachary, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.