NPIMap

Organization Active NPI

Southside Pediatrics. a.P.M.C.

  • Pediatrics Physician
  • Broussard, LA
National Provider Identifier
1609334390
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SOUTHSIDE PEDIATRICS. A.P.M.C.
Practice address
811 Albertson Pkwy Ste a
Broussard, LA 70518-5256
Phone
(337) 839-2238
NPI assigned
Mar 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Authorized official

Name
Dr. Carlos Bruno, MDNPI 1538153135
Title
President
Phone
(337) 839-2238

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

811 Albertson Pkwy Ste a
Broussard, LA 70518-5256

Mailing address

811 Albertson Pkwy Ste a
Broussard, LA 70518-5256
Phone (337) 839-2238

National Provider Directory

National Provider Directory

Locations

811 Albertson Pkwy
Ste A
Broussard, LA 70518
Phone (337) 839-2238

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": "1552348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1609334390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 ALBERTSON PKWY STE A",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705185256",
            "telephone_number": "337-839-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 ALBERTSON PKWY STE A",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705185256",
            "telephone_number": "337-839-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE PEDIATRICS. A.P.M.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "BRUNO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-839-2238",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broussard, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.