The Perkins Pediatric Clinic, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

14134R Issued in LA

Legal business name

THE PERKINS PEDIATRIC CLINIC, LLC

Practice address

614 N Pine St
Deridder, LA 70634-3546

Phone

(337) 462-6000

Fax

(337) 462-6560

NPI assigned

Dec 20, 2016

Last updated

Jan 8, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Barbara T Alston, DO

Title

Office Manager

Phone

(337) 462-6000

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1482192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546905600000",
    "number": "1649715079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 N PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706343546",
            "telephone_number": "337-462-6000",
            "fax_number": "337-462-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 N PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706343546",
            "telephone_number": "337-462-6000",
            "fax_number": "337-462-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PERKINS PEDIATRIC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-20",
        "last_updated": "2019-01-08",
        "status": "A",
        "authorized_official_last_name": "ALSTON",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "337-462-6000",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "14134R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1181137",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2482530",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adrienne D Thibodeau, LMT
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• Deborah Michelle Thompson, FNP-C

• Pediatrics Physician in Deridder, LA
• Providers in Deridder, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.