NPIMap

Organization Active NPI

MCMS, LLC

  • Primary Care Clinic/Center
  • Baker, LA
National Provider Identifier
1699177345
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
AP07509 Issued in LA
Legal business name
MCMS, LLC
Practice address
17625 Wisdom Dr
Baker, LA 70714-1536
Phone
(225) 505-5217
Fax
(225) 658-0099
NPI assigned
Sep 24, 2014
Last updated
Sep 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Authorized official

Name
Mrs. Mary Maxine McCrary, APRN, FNP-CNPI 1780017343
Title
Owner
Phone
(225) 505-5217

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X AP07509 LA Primary

Addresses

Primary practice location

17625 Wisdom Dr
Baker, LA 70714-1536

Mailing address

17625 Wisdom Dr
Baker, LA 70714-1536
Phone (225) 505-5217

Other identifiers 1

IdentifierTypeStateIssuer
2372041MedicaidLA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1699177345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17625 WISDOM DR",
            "city": "BAKER",
            "state": "LA",
            "postal_code": "707141536",
            "telephone_number": "225-505-5217",
            "fax_number": "225-658-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17625 WISDOM DR",
            "city": "BAKER",
            "state": "LA",
            "postal_code": "707141536",
            "telephone_number": "225-505-5217",
            "fax_number": "225-658-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "MCCRARY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "MAXINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-505-5217",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "LA",
            "license": "AP07509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2372041",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baker, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.