NPIMap

Organization Active NPI

Our Lake of the Lake Head and Neck Ce

  • Specialist
  • Baton Rouge, LA
National Provider Identifier
1619919271
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
OUR LAKE OF THE LAKE HEAD AND NECK CE
Practice address
7777 Hennessy Blvd
Ste 409
Baton Rouge, LA 70808-4300
Phone
(225) 765-1765
Fax
(225) 765-1768
NPI assigned
Jun 11, 2006
Last updated
May 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Authorized official

Name
Tamara White
Title
Director of Business Services
Phone
(225) 765-4251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

7777 Hennessy Blvd
Ste 409
Baton Rouge, LA 70808-4300

Mailing address

8415 Goodwood Blvd
Ste 105
Baton Rouge, LA 70806-7851
Phone (225) 765-4361

National Provider Directory

National Provider Directory

Locations

8415 Goodwood Blvd
Ste 105
Baton Rouge, LA 70806
Phone (225) 765-4226

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1619919271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 GOODWOOD BLVD",
            "address_2": "STE 105",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067851",
            "telephone_number": "225-765-4361",
            "fax_number": "225-765-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "STE 409",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-765-1765",
            "fax_number": "225-765-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LAKE OF THE LAKE HEAD AND NECK CE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS SERVICES",
        "authorized_official_telephone_number": "225-765-4251"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.