NPIMap

Organization Active NPI

Pelican State Industrial Medicine Inc Apmc

Doing business as Pelican State Outpatient Center

  • Urgent Care Clinic/Center
  • Harahan, LA
National Provider Identifier
1679527725
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PELICAN STATE INDUSTRIAL MEDICINE INC APMC
Doing business as
Pelican State Outpatient Center
Practice address
1525 Dickory Ave
Harahan, LA 70123-2168
Phone
(504) 818-0006
NPI assigned
May 22, 2006
Last updated
Apr 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Authorized official

Name
Dr. William M Kotler, MDNPI 1659768299
Title
Owner
Phone
(504) 818-0006

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
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1525 Dickory Ave
Harahan, LA 70123-2168

Mailing address

1525 Dickory Ave
Harahan, LA 70123-2168
Phone (504) 818-0006

Other names 1

  • Pelican State Outpatient Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040916000239 LA Part B Supplier - Clinic/Group Practice 4284613613 Receives reassigned benefits from 10 practitioners
Practice locations: Harahan, LA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D0976284Pelican State Outpatient Center1525 Dickory Avenue, Harahan, LA 70123Certificate of waiverDec 31, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1679527725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 DICKORY AVE",
            "city": "HARAHAN",
            "state": "LA",
            "postal_code": "701232168",
            "telephone_number": "504-818-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 DICKORY AVE",
            "city": "HARAHAN",
            "state": "LA",
            "postal_code": "701232168",
            "telephone_number": "504-818-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELICAN STATE INDUSTRIAL MEDICINE INC APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "KOTLER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-818-0006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pelican State Outpatient Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harahan, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.