Paul Ronald Clisham, MD

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

016589 Issued in LA

Practice address

1415 Tulane Ave
New Orleans, LA 70112-2600

Phone

(504) 988-5271

Fax

(504) 988-7655

NPI assigned

Oct 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Administrators of the Tulane Educational Fund

  dba Tulane University Medical Group

  • Specialist
  • New Orleans, LA
  • NPI 1528014164
  Medicare reassignment NPD
• Administrators of the Tulane Educational Fund

  • Specialist
  • Hattiesburg, MS
  • NPI 1033395298
  NPD
• Administrators of the Tulane Education Fund

  dba Tulane University Medical Group

  • Anatomic Pathology & Clinical Pathology Physician
  • New Orleans, LA
  • NPI 1790354595

  Maternal & Fetal Medicine

  NPD (past)
• New Fino LLC

  dba The Fertility Institute of New Orleans

  • Ambulatory Fertility Facility
  • Mandeville, LA
  • NPI 1558027201
  NPD (past)
• The Fertility Institute of New Orleans

  • Reproductive Endocrinology Physician
  • Mandeville, LA
  • NPI 1265644421
  NPD (past)
• University Healthcare System, L.C.

  dba LCMC Health Pharmacy Services-Lakeside

  • Community/Retail Pharmacy
  • Metairie, LA
  • NPI 1619446580
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1508942715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE",
            "address_2": "SL-11",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-988-5217",
            "fax_number": "504-988-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 TULANE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122600",
            "telephone_number": "504-988-5271",
            "fax_number": "504-988-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLISHAM",
        "first_name": "PAUL",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "LA",
            "license": "016589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1920126",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ebony Clifton, PHD, LPC
• Keiara Shermetra Cline
• Charles Garreth Clines
• Clinic Fast, Inc
• Clinical Consultants of Louisiana LLC (Dimitri Dermatology)
• CLLW Patterson LLC (Catch A Ride Transportation Services)
• Kimberley Clofer
• Shautera Clofer
• Amy Elizabeth Clomburg, PSYD
• Adam Cloninger, MD

• Maternal & Fetal Medicine Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Maternal & Fetal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.