Individual provider Active NPI

John Spence McClelland, M D

  • Cardiovascular Disease Physician
  • Baton Rouge, LA
National Provider Identifier
1639170962
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
05977R Issued in LA
Practice address
7777 Hennessy Blvd
Sutie 1000
Baton Rouge, LA 70808-4300
Phone
(225) 767-3900
Fax
(225) 214-9109
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 05977R LA Primary

Addresses

Primary practice location

7777 Hennessy Blvd
Sutie 1000
Baton Rouge, LA 70808-4300

Mailing address

7777 Hennessy Blvd
Sutie 1000
Baton Rouge, LA 70808-4300
Phone (225) 767-3900

Other identifiers 4

IdentifierTypeStateIssuer
060021708OtherLAPALMETTO GBA
232761OtherLAWELLCARE
2500227OtherLAUNITED HEALTHCARE
4211623OtherLAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100311000502 LA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Other (Physician) 0345254835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
05977RLAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Cardiovascular Specialists, LLC Cardiovascular Disease Current Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients

Locations

5228 Dijon Dr
Baton Rouge, LA 70808
Phone (225) 765-8829

7777 Hennessy Blvd
Ste 1000
Baton Rouge, LA 70808
Phone (225) 769-3900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1639170962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "SUTIE 1000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-767-3900",
            "fax_number": "225-214-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "SUTIE 1000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-767-3900",
            "fax_number": "225-214-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAND",
        "first_name": "JOHN",
        "middle_name": "SPENCE",
        "credential": "M D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "05977R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "060021708",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "232761",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2500227",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4211623",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.