Organization Active NPI

Richard J. Bidstrup, M.D. LTD.

  • Otolaryngology Physician
  • Opelousas, LA
National Provider Identifier
1528239555
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
L009234 Issued in LA
Legal business name
RICHARD J. BIDSTRUP, M.D. LTD.
Practice address
4049 I 49 S Service Rd
Opelousas, LA 70570-0757
Phone
(337) 942-2674
Fax
(337) 948-1858
NPI assigned
Mar 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Dr. Richard J. Bidstrup, M.D.
Title
Physician
Phone
(337) 942-2674

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X L009234 LA Primary

Addresses

Primary practice location

4049 I 49 S Service Rd
Opelousas, LA 70570-0757

Mailing address

4049 I 49 S Service Rd
Opelousas, LA 70570-0757
Phone (337) 942-2674

Other identifiers 2

IdentifierTypeStateIssuer
4354896360OtherLABLUE CROSS BLUE SHIELD LA
1153834MedicaidLA

Other names 1

  • Ear, Nose, Throat, and Allergy Clinic Other name

National Provider Directory

National Provider Directory

Locations

4049 I 49 S Service Rd
Opelousas, LA 70570
Phone (337) 942-2674

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1528239555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4049 I 49 S SERVICE RD",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705700757",
            "telephone_number": "337-942-2674",
            "fax_number": "337-948-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 I 49 S SERVICE RD",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705700757",
            "telephone_number": "337-942-2674",
            "fax_number": "337-948-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD J. BIDSTRUP, M.D. LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "BIDSTRUP",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "337-942-2674",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "L009234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD LA",
            "identifier": "4354896360",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1153834",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ear, Nose, Throat, and Allergy Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Opelousas, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.