NPIMap

Organization Active NPI

West Jefferson Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Marrero, LA
National Provider Identifier
1508850413
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
WEST JEFFERSON SURGERY CENTER LLC
Practice address
1111 Medical Center Blvd
Ste 105 North
Marrero, LA 70072
Phone
(504) 349-2332
Fax
(504) 349-2359
NPI assigned
Sep 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Gwendolyn Morvant McInnis, RN MHA
Title
Administrator
Phone
(504) 349-6017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X LA Primary

Addresses

Primary practice location

1111 Medical Center Blvd
Ste 105 North
Marrero, LA 70072

Mailing address

1111 Medical Center Blvd
Ste 105 North
Marrero, LA 70072
Phone (504) 349-2332

Other identifiers 3

IdentifierTypeStateIssuer
115OtherLIC
A50004330OtherSTATE
1150011MedicaidLA

Other names 1

  • Gwen McInnis Administrator Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508850413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "STE 105 NORTH",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-2332",
            "fax_number": "504-349-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "STE 105 NORTH",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-2332",
            "fax_number": "504-349-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST JEFFERSON SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCINNIS",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "MORVANT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "504-349-6017",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN MHA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "115",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "A50004330",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1150011",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gwen McInnis Administrator",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.