Health Clinic of Moss Bluff, LLC

Key facts

NPI: 1679904387
Entity type: Organization (NPI type 2)
Primary specialty: Internal Medicine Physician 207R00000X
License: 13083R (LA)
Legal business name: HEALTH CLINIC OF MOSS BLUFF, LLC
Practice address: 237 Sam Houston Jones Pkwy
Moss Bluff, LA 70611-5603
Phone: (337) 786-5007
Fax: (337) 786-5009
NPI assigned: Dec 5, 2013
Organization subpart: No

Authorized official

Name: Jagjit S Chadha, MD NPI 1144377128
Title: Ceo/Owner
Phone: (337) 786-5007

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 5

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

Jagjit Chadha, M.D Internal Medicine Physician · Dequincy, LA · NPI 1144377128

Medicare reassignment NPD Authorized official INTERNAL MEDICINE · LA
Robin Shirley Bedgood, NP Family Nurse Practitioner · Dequincy, LA · NPI 1336490986

Medicare reassignment NPD LA
Nandita Chadha, M.D. Family Medicine Physician · Dequincy, LA · NPI 1558418533

Medicare reassignment NPD FAMILY MEDICINE · LA
Nafeesa Hashmi, FNP Family Medicine Physician · Dequincy, LA · NPI 1538669361

Medicare reassignment NPD FAMILY MEDICINE · LA
Alicia Larocque, APRN Family Nurse Practitioner · Lake Charles, LA · NPI 1164845905

Medicare reassignment NPD LA

Medicare participation

Medicare fee-for-service enrollment: Enrolled in LA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20140320001496	LA	Part B Supplier - Clinic/Group Practice	2961633714	Receives reassigned benefits from 5 practitioners Practice locations: Lake Charles, LA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207Q00000X	13084R	LA
Internal Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207R00000X	13083R	LA	Yes

Addresses

Primary practice location

237 Sam Houston Jones Pkwy
Moss Bluff, LA 70611-5603

Mailing address

140 W 4TH St
Dequincy, LA 70633-3508
Phone (337) 786-5007

Other names

CHADHA MEDICAL CLINIC - MB Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 3, 2014.

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391385600000",
    "number": "1679904387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W 4TH ST",
            "city": "DEQUINCY",
            "state": "LA",
            "postal_code": "706333508",
            "telephone_number": "337-786-5007",
            "fax_number": "337-786-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 SAM HOUSTON JONES PKWY",
            "city": "MOSS BLUFF",
            "state": "LA",
            "postal_code": "706115603",
            "telephone_number": "337-786-5007",
            "fax_number": "337-786-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CLINIC OF MOSS BLUFF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-05",
        "last_updated": "2014-02-03",
        "status": "A",
        "authorized_official_last_name": "CHADHA",
        "authorized_official_first_name": "JAGJIT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "337-786-5007",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "13084R",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "13083R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHADHA MEDICAL CLINIC - MB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moss Bluff, LA

All providers in Moss Bluff, LA · Internal Medicine Physician in Louisiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.