NPIMap

Organization Active NPI

St Martin Hospital, Inc.

Doing business as St Martin Hospital Wound Care

  • Medical Specialty Clinic/Center
  • Breaux Bridge, LA
National Provider Identifier
1619469202
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
672 Issued in LA
Legal business name
ST MARTIN HOSPITAL, INC.
Doing business as
St Martin Hospital Wound Care
Practice address
1555 Gary Dr Ste a
Breaux Bridge, LA 70517-3448
Phone
(337) 909-2474
NPI assigned
May 31, 2018
Last updated
Jan 22, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ST MARTIN HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Authorized official

Name
Sandra Keller
Title
VP Compliance
Phone
(337) 289-8684

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 672 LA Primary
Critical Access Hospital 282NC0060X 672 LA

Addresses

Primary practice location

1555 Gary Dr Ste a
Breaux Bridge, LA 70517-3448

Mailing address

920 W Pinhook Rd
Lafayette, LA 70503-2455
Phone (337) 289-8684

Other identifiers 1

IdentifierTypeStateIssuer
61561OtherLABLUE CROSS BLUE SHIELD

Other names 2

  • St Martin Hospital Wound Care Doing business as
  • St. Martin Hospital Specialty Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101020001032 LA Part B Supplier - Clinic/Group Practice 4688720782 Receives reassigned benefits from 43 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Breaux Bridge, LA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
St Martin Hospital Inc7 organizations share this tax ID, including this one
Part of
St Martin Hospital Inc

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1555 Gary Dr
#A
Breaux Bridge, LA 70517
Phone (337) 909-2474

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579651200000",
    "number": "1619469202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 W PINHOOK RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032455",
            "telephone_number": "337-289-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 GARY DR STE A",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173448",
            "telephone_number": "337-909-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARTIN HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST MARTIN HOSPITAL, INC.",
        "enumeration_date": "2018-05-31",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "VP COMPLIANCE",
        "authorized_official_telephone_number": "337-289-8684"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "LA",
            "license": "672",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "LA",
            "license": "672",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "61561",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Martin Hospital Wound Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Martin Hospital Specialty Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Breaux Bridge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.

Verify at the official NPI Registry.