Organization Active NPI

M Stoglin Edd Aprn PMH Services, Inc

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Monroe, LA
National Provider Identifier
1639395502
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
RN048404 AP02772 Issued in LA
Legal business name
M STOGLIN EDD APRN PMH SERVICES, INC
Practice address
300 Washington St
Suite 208
Monroe, LA 71201-6714
Phone
(318) 322-8482
NPI assigned
Apr 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Authorized official

Name
Mary Stoglin, CNS
Title
Owner
Phone
(318) 322-8482

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SP0808X RN048404 AP02772 LA Primary

Addresses

Primary practice location

300 Washington St
Suite 208
Monroe, LA 71201-6714

Mailing address

300 Washington St
Suite 208
Monroe, LA 71201-6714
Phone (318) 322-8482

Other identifiers 1

IdentifierTypeStateIssuer
1688193MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071217000074 LA Part B Supplier - Clinic/Group Practice 6204926132 Receives reassigned benefits from 1 practitioner
Practice locations: Monroe, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403827200000",
    "number": "1639395502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WASHINGTON ST",
            "address_2": "SUITE 208",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712016714",
            "telephone_number": "318-322-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WASHINGTON ST",
            "address_2": "SUITE 208",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712016714",
            "telephone_number": "318-322-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M STOGLIN EDD APRN PMH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2014-06-27",
        "status": "A",
        "authorized_official_last_name": "STOGLIN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-322-8482",
        "authorized_official_credential": "CNS"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "LA",
            "license": "RN048404  AP02772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1688193",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; 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.