Ochsner Lsu Health Shreveport - St. Mary Medical Center, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

OCHSNER LSU HEALTH SHREVEPORT - ST. MARY MEDICAL CENTER, LLC

Practice address

1 Saint Mary PL
Shreveport, LA 71101-4307

Phone

(318) 626-4300

NPI assigned

Nov 15, 2021

Last updated

Nov 15, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

OCHSNER LSU HEALTH SHREVEPORT - ST. MARY MEDICAL CENTER, LLCAs reported in NPPES

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

Authorized official

Name

Vernon Moore

Title

Cfo

Phone

(318) 626-0990

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Ochsner Lsu Health Shreveport - St. Mary Medical Center, LLC

  dba Ochsner LSU Health Shreveport - St. Mary Medical Center

  • Women's Hospital
  • Shreveport, LA
  • NPI 1285253252

  O20200917001890

  Same enrollment

Part of

Ochsner Lsu HLTH Shreveport

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1508522558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W KIRBY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033822",
            "telephone_number": "318-626-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT MARY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014307",
            "telephone_number": "318-626-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCHSNER LSU HEALTH SHREVEPORT - ST. MARY MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OCHSNER LSU HEALTH SHREVEPORT - ST. MARY MEDICAL CENTER, LLC",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "VERNON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "318-626-0990"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franz Albert Obusan, MD
• Obvamc
• Ocean Dental of Louisiana, P.C.
• Ochsner Lsu Health Shreveport - St. Mary Medical Center, LLC (Ochsner LSU Health Shreveport - St. Mary Medical Center)
• Ochsner Lsu Health Shreveport - St. Mary Medical Center, LLC (Ochsner LSU Health Shreveport - St. Mary Medical Center)
• Jared Ocmand, PHARM.D
• Emamoke Odafe, MD
• Odell LLC (Messiah Medical)
• Alexander Oderhowho, MD
• Amira Odisho, MBBS

• Obstetrics & Gynecology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Obstetrics & Gynecology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.