Individual provider Active NPI

Baptiste William Brunner III, MD

  • Urology Physician
  • Covington, LA
National Provider Identifier
1528063732
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
010614 Issued in LA
Practice address
67250 Industry LN
Ste B
Covington, LA 70433-8716
Phone
(985) 892-3456
Fax
(985) 892-3499
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 010614 LA Primary

Addresses

Primary practice location

67250 Industry LN
Ste B
Covington, LA 70433-8716

Mailing address

301 Silver Oaks LN
River Ridge, LA 70123-2030
Phone (504) 737-2999

Other identifiers 1

IdentifierTypeStateIssuer
1365939MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070511000386 LA Practitioner - Urology 1254438047 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10614LAMDClinical Social Worker
010614LAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsuhn Billing LLC CurrentSince Apr 28, 2008 Accepting new patients
Lsuhn Billing LLC CurrentSince Apr 28, 2008 Accepting new patients

Locations

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1528063732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SILVER OAKS LN",
            "city": "RIVER RIDGE",
            "state": "LA",
            "postal_code": "701232030",
            "telephone_number": "504-737-2999",
            "fax_number": "504-737-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67250 INDUSTRY LN",
            "address_2": "STE B",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338716",
            "telephone_number": "985-892-3456",
            "fax_number": "985-892-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "BAPTISTE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "LA",
            "license": "010614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1365939",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; 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.