Active NPI
Stephen G Scully M D Carol W Sartin M D & Susan G Scioneaux M D P M C
- Anatomic Pathology & Clinical Pathology Physician
- Metairie, LA
National Provider Identifier
1609943018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- Legal business name
- STEPHEN G SCULLY M D CAROL W SARTIN M D & SUSAN G SCIONEAUX M D P M C
- Practice address
- 4648 I 10 Service Road
Metairie, LA 70001 - Phone
- (504) 883-4800
- Fax
- (504) 883-5554
- NPI assigned
- Nov 29, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephen Gerald Scully, MD
- Title
- President
- Phone
- (985) 230-7263
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cytopathology Physician | 207ZC0500X | |||
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | Primary |
Addresses
Primary practice location
4648 I 10 Service Road
Metairie, LA 70001
Mailing address
PO Box 73309
Metairie, LA 70033-3309
Phone (504) 883-4800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1940577 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
4228 Houma Blvd
Ste 325
Metairie, LA 70006
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Anatomic Pathology & Clinical Pathology Physician
- Metairie, LA
- NPI 1568539963
-
- Anatomic Pathology & Clinical Pathology Physician
- Metairie, LA
- NPI 1396820981
Cytopathology
-
- Clinical Pathology/Laboratory Medicine Physician
- Metairie, LA
- NPI 1730264326
Cytopathology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214179200000",
"number": "1609943018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 73309",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700333309",
"telephone_number": "504-883-4800",
"fax_number": "504-883-5554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4648 I 10 SERVICE ROAD",
"city": "METAIRIE",
"state": "LA",
"postal_code": "70001",
"telephone_number": "504-883-4800",
"fax_number": "504-883-5554"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STEPHEN G SCULLY M D CAROL W SARTIN M D & SUSAN G SCIONEAUX M D P M C",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-29",
"last_updated": "2008-06-23",
"status": "A",
"authorized_official_last_name": "SCULLY",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "GERALD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "985-230-7263",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207ZC0500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pathology, Cytopathology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1940577",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.