NPIMap

Organization Active NPI

Bianchini-Holcomb

  • Clinical Neuropsychologist
  • Mandeville, LA
National Provider Identifier
1700276490
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1310 Issued in LA
Legal business name
BIANCHINI-HOLCOMB
Practice address
4050 Lonesome Rd Ste a
Mandeville, LA 70448-7085
Phone
(985) 246-2600
Fax
(985) 246-6100
NPI assigned
Feb 2, 2015
Last updated
Oct 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Authorized official

Name
Kevin Bianchini, PHDNPI 1780729939
Title
Manager Member
Phone
(504) 780-1702

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
Clinical Neuropsychologist 103G00000X 1310 LA Primary

Addresses

Primary practice location

4050 Lonesome Rd Ste a
Mandeville, LA 70448-7085

Mailing address

2901 N I 10 Service Rd E
Ste 300
Metairie, LA 70002-6137
Phone (504) 780-1702

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161214000376 LA Part B Supplier - Clinic/Group Practice 4880996925 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, LA; Mandeville, LA; Metairie, LA; New Orleans, LA

National Provider Directory

National Provider Directory

Locations

6555 Perkins Rd
Ste 500
Baton Rouge, LA 70808
Phone (225) 368-2297

4050 Lonesome Rd
Ste 500
Mandeville, LA 70448

Practitioners & affiliated clinicians

Practitioners 5

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": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1700276490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N I 10 SERVICE RD E",
            "address_2": "STE 300",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700026137",
            "telephone_number": "504-780-1702",
            "fax_number": "504-780-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 LONESOME RD STE A",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487085",
            "telephone_number": "985-246-2600",
            "fax_number": "985-246-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIANCHINI-HOLCOMB",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "BIANCHINI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGER MEMBER",
        "authorized_official_telephone_number": "504-780-1702",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "LA",
            "license": "1310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.