Outpatient Medical Nutrition Therapy

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

157H Issued in LA

Legal business name

OUTPATIENT MEDICAL NUTRITION THERAPY

Practice address

920 Oliver Road
Suite 1450
Monroe, LA 71201-7529

Phone

(318) 327-6271

Fax

(318) 327-5260

NPI assigned

Oct 25, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Ronald Hogan

Title

Cfo Sr VP

Phone

(318) 327-7369

Specialties & licenses 1

Addresses

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• St. Francis Medical Center, Inc.

  • Primary Care Clinic/Center
  • Monroe, LA
  • NPI 1437552106

  Member Of

  NPD member
• Franciscan Missionaries of Our Lady Health System Inc

  • Pharmacy
  • Jackson, MS
  • NPI 1932892601

  Member Of

  NPD member

Locations

Practitioners 2

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

• Thomas James Gullatt, MD

  • Pulmonary Disease Physician
  • Monroe, LA
  • NPI 1154487627
  NPD (past)
• Meghan Tooke Kavanaugh

  • Family Nurse Practitioner
  • Ruston, LA
  • NPI 1548418189
  NPD (past)

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1508856253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1901",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712101901",
            "telephone_number": "318-327-4073",
            "fax_number": "318-327-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 OLIVER ROAD",
            "address_2": "SUITE 1450",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017529",
            "telephone_number": "318-327-6271",
            "fax_number": "318-327-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTPATIENT MEDICAL NUTRITION THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "HOGAN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "CFO SR VP",
        "authorized_official_telephone_number": "318-327-7369",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "LA",
            "license": "157H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ouachita Parish School Board
• Ouachita Physical Therapy,Inc.
• Ouachita Rehabilitation, LLC
• Akiava Outley
• Brandy Outley
• Outpatient Physician Practice No 5
• James Roath Owens, FNP-C
• Lee Anne Owens
• Nakirria Owens
• Oshea Owens II

• Clinic/Center in Monroe, LA
• Providers in Monroe, LA by specialty
• Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.