Individual provider Active NPI

Luis Gabriel Uribe, MD

  • Nephrology Physician
  • Kenner, LA
National Provider Identifier
1750334702
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
07422R Issued in LA
Practice address
200 W Esplanade
#103
Kenner, LA 70065
Phone
(504) 464-8712
Fax
(504) 464-8711
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 07422R LA Primary

Addresses

Primary practice location

200 W Esplanade
#103
Kenner, LA 70065

Mailing address

200 W Esplanade
#103
Kenner, LA 70065
Phone (504) 464-8712

Other identifiers 1

IdentifierTypeStateIssuer
1368644MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07422RLAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Institute of Nephrology, LLC (Win) Nephrology PastSince May 16, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1750334702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ESPLANADE",
            "address_2": "#103",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "70065",
            "telephone_number": "504-464-8712",
            "fax_number": "504-464-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ESPLANADE",
            "address_2": "#103",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "70065",
            "telephone_number": "504-464-8712",
            "fax_number": "504-464-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URIBE",
        "first_name": "LUIS",
        "middle_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "07422R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1368644",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenner, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.