NPIMap

Organization Active NPI

East Jefferson Emergency Management LLC

  • Emergency Medicine Physician
  • Metairie, LA
National Provider Identifier
1639684061
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EAST JEFFERSON EMERGENCY MANAGEMENT LLC
Practice address
4200 Houma Blvd
Metairie, LA 70006-2970
Phone
(504) 454-4000
NPI assigned
Dec 7, 2017
Last updated
Jan 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Authorized official

Name
Roland S Waguespack III, MDNPI 1992762322
Title
Owner
Phone
(504) 503-4196

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

4200 Houma Blvd
Metairie, LA 70006-2970

Mailing address

6880 W Snowville Rd Ste 210
Brecksville, OH 44141-3255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180110000039 LA Part B Supplier - Clinic/Group Practice 8325307937 Receives reassigned benefits from 20 practitioners
Practice locations: Metairie, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1639684061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6880 W SNOWVILLE RD STE 210",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441413255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062970",
            "telephone_number": "504-454-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST JEFFERSON EMERGENCY MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-07",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "WAGUESPACK",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-503-4196",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.