Organization Active NPI

Friendly Care Diagnostic Services Inc

  • General Practice Physician
  • Metairie, LA
National Provider Identifier
1679862403
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FRIENDLY CARE DIAGNOSTIC SERVICES INC
Practice address
3216 N Turnbull Dr
Suite C
Metairie, LA 70002-5732
Phone
(504) 885-6932
Fax
(504) 885-2987
NPI assigned
Apr 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

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

Authorized official

Name
Sergo Kutelia
Title
Ceo
Phone
(818) 219-7003

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

3216 N Turnbull Dr
Suite C
Metairie, LA 70002-5732

Mailing address

3216 N Turnbull Dr
Suite C
Metairie, LA 70002-5732
Phone (504) 885-6932

Other identifiers 1

IdentifierTypeStateIssuer
2111205MedicaidLA

National Provider Directory

National Provider Directory

Locations

3216 N Turnbull Dr
#C
Metairie, LA 70002
Phone (504) 885-6932

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1679862403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 N TURNBULL DR",
            "address_2": "SUITE C",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700025732",
            "telephone_number": "504-885-6932",
            "fax_number": "504-885-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 N TURNBULL DR",
            "address_2": "SUITE C",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700025732",
            "telephone_number": "504-885-6932",
            "fax_number": "504-885-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDLY CARE DIAGNOSTIC SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "KUTELIA",
        "authorized_official_first_name": "SERGO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-219-7003"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2111205",
            "state": "LA"
        }
    ],
    "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 Apr 1, 2011; 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.