Mitchell Lee Rodeheaver, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

331055 Issued in LA

Practice address

1112 E Ascension Complex Blvd
Gonzales, LA 70737-4265

Phone

(225) 450-1016

Fax

(225) 450-1150

NPI assigned

Mar 24, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Psychiatry

Education

Louisiana State University School of Medicine in Shreveport, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

Merit-based Incentive Payment System (MIPS)

Final score

88.35 of 100Reported as group

Quality

80.15

Promoting interoperability

100

Improvement activities

40

Cost

76.19

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mrodeheaver1271184@direct.casso.us.com

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.

• Our Lady of the Lake Physician Group LLC

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1033494943

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Our Lady of the Lake Physician Group LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baton Rouge, LA
  • NPI 1235912502
  NPD
• Our Lady of the Lake Physician Group, LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1588062079
  NPD
• Our Lady of the Lake Physician Group LLC

  • Hematology & Oncology Physician
  • Baton Rouge, LA
  • NPI 1184671455
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Our Lady of the Lake Hospital Inc.

  • General Acute Care Hospital
  • Baton Rouge, LA
  • NPI 1366436123
  Care Compare affiliation

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1558998211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 E ASCENSION COMPLEX BLVD # A",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374265",
            "telephone_number": "225-450-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 E ASCENSION COMPLEX BLVD",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374265",
            "telephone_number": "225-450-1016",
            "fax_number": "225-450-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13535 Mosher Ct",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708105065",
            "country_code": "US",
            "telephone_number": "281-387-1178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODEHEAVER",
        "first_name": "MITCHELL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": "322824",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "331055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latonya Robinson
• Moriah Christian Robinson
• Reese Sy Robinson, PA-C
• Sharelle Robinson, DNP, FNP
• Tyonia Robinson
• Caroline Cazayoux Rolfsen, DDS
• Byron R Rome, DDS, APDC
• Claudia Rome, DC, MS
• Omaira Trinidad Romero
• Rosemond School of Phlebotomy Clinical Laboratory-Research & Testing,

• Psychiatry Physician in Gonzales, LA
• Providers in Gonzales, LA by specialty
• Psychiatry Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.