NPIMap

Organization Active NPI

Southern Diagnostic Center, Inc.

  • Diagnostic Radiology Physician
  • Lafayette, LA
National Provider Identifier
1649225673
Registry record updated Jan 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SOUTHERN DIAGNOSTIC CENTER, INC.
Practice address
1101 S College Rd
Suite 200
Lafayette, LA 70503-3038
Phone
(337) 269-5990
Fax
(337) 232-3295
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2010

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

Authorized official

Name
Mrs. Donna G Robinson
Title
Office Contract Manager
Phone
(337) 269-5990

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1101 S College Rd
Suite 200
Lafayette, LA 70503-3038

Mailing address

1101 S College Rd
Suite 200
Lafayette, LA 70503-3038
Phone (337) 269-5990

Other identifiers 2

IdentifierTypeStateIssuer
1793981MedicaidLA
300071001OtherLAMEDICARE RAILROAD RET

Other names 1

  • Laborde Diagnotics at South College Doing business as

National Provider Directory

National Provider Directory

Locations

309 Saint Julien Ave
Ste 200
Lafayette, LA 70506
Phone (337) 237-3424

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1649225673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S COLLEGE RD",
            "address_2": "SUITE 200",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033038",
            "telephone_number": "337-269-5990",
            "fax_number": "337-232-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S COLLEGE RD",
            "address_2": "SUITE 200",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033038",
            "telephone_number": "337-269-5990",
            "fax_number": "337-232-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DIAGNOSTIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE CONTRACT MANAGER",
        "authorized_official_telephone_number": "337-269-5990",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1793981",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD RET",
            "identifier": "300071001",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laborde Diagnotics at South College",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.