NPIMap

Individual provider Active NPI

George Fakhre

  • Internal Medicine Physician
  • Lake Providence, LA
National Provider Identifier
1750310272
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12401R Issued in LA
Practice address
221 N Hood
Lake Providence, LA 71254
Phone
(318) 559-1221
NPI assigned
Jun 30, 2006
Last updated
Jul 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12401R LA Primary

Addresses

Primary practice location

221 N Hood
Lake Providence, LA 71254

Mailing address

706 Ross St
Oak Grove, LA 71263-9798
Phone (318) 428-4964

Other identifiers 1

IdentifierTypeStateIssuer
1534641MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803000312 LA Practitioner - Internal Medicine 0840323499 Reassigns benefits to 3 organizations
Practice locations: Oak Grove, LA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Miami, LM Miller School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Carroll Health Systems, LLCGroup PAC ID 5294627774, shared by 8 NPIs, 21 clinicians

Practice addresses (Care Compare)

706 Ross St
Oak Grove, LA 71263-9798
Phone (318) 428-3237

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12401RLAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Carroll Health Systems LLC Current Accepting new patients
West Carroll Health Systems LLC CurrentSince Dec 1, 2002 Accepting new patients
West Carroll Health Systems LLC CurrentSince Dec 1, 2002 Accepting new patients
West Carroll Care Center Inc Past Accepting new patients
West Carroll Health Systems LLC Past Accepting new patients

Locations

706 Ross St
Oak Grove, LA 71263
Phone (318) 428-3237

Interoperability endpoints

  • Direct secure messaging: gfakhre@wchs.securechart.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1750310272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 ROSS ST",
            "city": "OAK GROVE",
            "state": "LA",
            "postal_code": "712639798",
            "telephone_number": "318-428-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 N HOOD",
            "city": "LAKE PROVIDENCE",
            "state": "LA",
            "postal_code": "71254",
            "telephone_number": "318-559-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHRE",
        "first_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "12401R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1534641",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Providence, LA

Sources for this page

Verify at the official NPI Registry.