NPIMap

Organization Active NPI

Louisiana State University School of Medicine in New Orleans Faculty G

  • Dentist
  • New Orleans, LA
National Provider Identifier
1740534064
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS FACULTY G
Practice address
478 S Johnson St FL 6
New Orleans, LA 70112-2238
Phone
(504) 412-1819
NPI assigned
Nov 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

Name
Atara McAvoy
Title
Chief Financial Officer
Phone
(504) 412-1819

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

478 S Johnson St FL 6
New Orleans, LA 70112-2238

Mailing address

478 S Johnson St FL 6
New Orleans, LA 70112-2238

Other names 1

  • LSU Healthcare Network Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031209000661 LA Part B Supplier - Clinic/Group Practice 0244136448 Receives reassigned benefits from 923 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lsu Health Care Network7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4500 10th St
Ste B
Marrero, LA 70072
Phone (504) 412-1960

478 S Johnson St
Fl 6
New Orleans, LA 70112
Phone (504) 412-1819

478 S Johnson St
New Orleans, LA 70112
Phone (504) 412-1366

Practitioners & affiliated clinicians

Practitioners 247

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

View all 247

NPI Registry JSON

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1740534064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 S JOHNSON ST FL 6",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 S JOHNSON ST FL 6",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122238",
            "telephone_number": "504-412-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS FACULTY G",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-08",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "MCAVOY",
        "authorized_official_first_name": "ATARA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "504-412-1819"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LSU Healthcare Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.