NPIMap

Organization Active NPI

Diagnostic and Interventional Spinal Care of Louisiana

  • Orthopaedic Surgery of the Spine Physician
  • Covington, LA
National Provider Identifier
1659616696
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
DIAGNOSTIC AND INTERVENTIONAL SPINAL CARE OF LOUISIANA
Practice address
76 Starbrush Cir
Covington, LA 70433-7208
Phone
(844) 800-3472
Fax
(844) 355-3472
NPI assigned
Dec 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Authorized official

Name
Khader Samer Fayez Shamieh, M.D.
Title
President
Phone
(844) 800-3472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X Primary

Addresses

Primary practice location

76 Starbrush Cir
Covington, LA 70433-7208

Mailing address

76 Starbrush Cir
Covington, LA 70433-7208
Phone (844) 800-3472

Other names 1

  • DISC of Louisiana Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140313000854 LA Part B Supplier - Clinic/Group Practice 0244460293 Receives reassigned benefits from 12 practitioners
Practice locations: Slidell, LA; Hammond, LA; Metairie, LA; Houma, LA; Covington, LA
O20140612000831 LA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0244460293 Practice locations: Covington, LA

National Provider Directory

National Provider Directory

Locations

4441 N I 10 Service Rd W
Metairie, LA 70006
Phone (985) 400-5778

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1659616696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 STARBRUSH CIR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337208",
            "telephone_number": "844-800-3472",
            "fax_number": "844-355-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 STARBRUSH CIR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337208",
            "telephone_number": "844-800-3472",
            "fax_number": "844-355-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC AND INTERVENTIONAL SPINAL CARE OF LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-03",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "SHAMIEH",
        "authorized_official_first_name": "KHADER SAMER",
        "authorized_official_middle_name": "FAYEZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "844-800-3472",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DISC of Louisiana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.