NPIMap

Organization Active NPI

River West Clinic Corp.

  • Surgery Physician
  • Plaquemine, LA
National Provider Identifier
1588738272
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
RIVER WEST CLINIC CORP.
Practice address
59335 River West Dr
Suite B
Plaquemine, LA 70764-6553
Phone
(225) 687-5594
Fax
(225) 687-5595
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Charles J Fulner
Title
Executive VP Licensure
Phone
(502) 253-0771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

59335 River West Dr
Suite B
Plaquemine, LA 70764-6553

Mailing address

PO Box 2121
Lowell, AR 72745-2121
Phone (502) 253-0771

National Provider Directory

National Provider Directory

Locations

59335 River West Dr
#B
Plaquemine, LA 70764
Phone (225) 385-4543

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1588738272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2121",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727452121",
            "telephone_number": "502-253-0771",
            "fax_number": "502-253-0683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59335 RIVER WEST DR",
            "address_2": "SUITE B",
            "city": "PLAQUEMINE",
            "state": "LA",
            "postal_code": "707646553",
            "telephone_number": "225-687-5594",
            "fax_number": "225-687-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER WEST CLINIC CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "FULNER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE VP LICENSURE",
        "authorized_official_telephone_number": "502-253-0771"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plaquemine, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.