Organization Active NPI

Oh Project- Northshore

  • General Practice Physician
  • Covington, LA
National Provider Identifier
1700354453
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
OH PROJECT- NORTHSHORE
Practice address
190 Greenbrier Blvd Ste 105
Covington, LA 70433-7237
Phone
(985) 276-3040
NPI assigned
Nov 9, 2018
Last updated
Nov 9, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
OHANA HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Authorized official

Name
Tyrone Luster
Title
Owner
Phone
(901) 626-2129

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

190 Greenbrier Blvd Ste 105
Covington, LA 70433-7237

Mailing address

PO Box 957
Madisonville, LA 70447-0957

National Provider Directory

National Provider Directory
Part of
Oh Project- Northshore

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": "1541721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541721600000",
    "number": "1700354453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 957",
            "city": "MADISONVILLE",
            "state": "LA",
            "postal_code": "704470957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 GREENBRIER BLVD STE 105",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337237",
            "telephone_number": "985-276-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OH PROJECT- NORTHSHORE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OHANA HEALTHCARE",
        "enumeration_date": "2018-11-09",
        "last_updated": "2018-11-09",
        "status": "A",
        "authorized_official_last_name": "LUSTER",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-626-2129"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.