NPIMap

Organization Active NPI

Westbank Renal Associates, LLC

  • Internal Medicine Physician
  • Marrero, LA
National Provider Identifier
1528255189
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
03747R Issued in LA
Legal business name
WESTBANK RENAL ASSOCIATES, LLC
Practice address
1111 Medical Center Blvd
Suite N 304
Marrero, LA 70072-3151
Phone
(504) 349-6808
Fax
(504) 349-6811
NPI assigned
Sep 27, 2007
Last updated
Jan 27, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Authorized official

Name
Dr. Chakkungal P. Devidoss, M.D
Title
Owner
Phone
(504) 349-6808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 03747R LA Primary

Addresses

Primary practice location

1111 Medical Center Blvd
Suite N 304
Marrero, LA 70072-3151

Mailing address

1111 Medical Center Blvd
Suite N 304
Marrero, LA 70072-3151
Phone (504) 349-6808

Other identifiers 1

IdentifierTypeStateIssuer
1347787MedicaidLA

National Provider Directory

National Provider Directory

Locations

535 Commerce St
Ste B
Gretna, LA 70056
Phone (504) 391-1500

1111 Medical Center Blvd
Ste N304
Marrero, LA 70072
Phone (504) 349-6325

2924 General Degaulle Dr
New Orleans, LA 70114
Phone (504) 361-8042

1 Westbank Expy
Westwego, LA 70094
Phone (504) 347-6942

Practitioners & affiliated clinicians

Practitioners 1

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": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1528255189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE N 304",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6808",
            "fax_number": "504-349-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE N 304",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6808",
            "fax_number": "504-349-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTBANK RENAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "DEVIDOSS",
        "authorized_official_first_name": "CHAKKUNGAL",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-349-6808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "03747R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1347787",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 27, 2009; 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.