NPIMap

Organization Active NPI

Our Lady of the Lake Plastic Clinic

Doing business as Our Lady of the Lake Regional Medical Center

  • Plastic Surgery Physician
  • Baton Rouge, LA
National Provider Identifier
1639360704
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
OUR LADY OF THE LAKE PLASTIC CLINIC
Doing business as
Our Lady of the Lake Regional Medical Center
Practice address
7777 Hennessy Blvd
Suite 709
Baton Rouge, LA 70808-4300
Phone
(225) 765-7731
NPI assigned
Aug 5, 2007
Last updated
May 19, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
OUR LADY OF THE LAKE HOSPITAL, INC.As reported in NPPES

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
Mr. Tamara D White Jr.
Title
Director of Business Services
Phone
(225) 765-4251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

7777 Hennessy Blvd
Suite 709
Baton Rouge, LA 70808-4300

Mailing address

7777 Hennessy Blvd
Suite 709
Baton Rouge, LA 70808-4300
Phone (225) 765-7731

Other names 1

  • Our Lady of the Lake Regional Medical Center Doing business as

National Provider Directory

National Provider Directory
Part of
Our Lady of the Lake Re

Member of 2

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

Locations

4950 Essen Ln
Ste 400
Baton Rouge, LA 70809
Phone (225) 765-1765

4950 Essen Ln
Ste C
Baton Rouge, LA 70809
Phone (225) 765-1982

7777 Hennessy Blvd
Ste 708
Baton Rouge, LA 70808

7777 Hennessy Blvd
Ste 709
Baton Rouge, LA 70808
Phone (225) 765-7735

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1639360704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "SUITE 709",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-765-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "SUITE 709",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-765-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF THE LAKE PLASTIC CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUR LADY OF THE LAKE HOSPITAL, INC.",
        "enumeration_date": "2007-08-05",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS SERVICES",
        "authorized_official_telephone_number": "225-765-4251",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Our Lady of the Lake Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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.