Shalom Clinic for Children Apmc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

200937 Issued in LA

Legal business name

SHALOM CLINIC FOR CHILDREN APMC

Practice address

405 Bienville St
Natchitoches, LA 71457-5748

Phone

(318) 356-7211

Fax

(318) 356-7226

NPI assigned

Dec 19, 2006

Last updated

Nov 23, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Olusegun Adedamola Adeleye, M.D.NPI 1629023064

Title

President

Phone

(318) 356-7211

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Shalom Clinic for Children Apmc

  dba Behavioral Health Services @Shalom Clinic for Children APMC

  • Child & Adolescent Psychiatry Physician
  • Natchitoches, LA
  • NPI 1356957518
  NPPES parent name

Practitioners 2

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.

• Olusegun Adedamola Adeleye, M.D.

  • Pediatrics Physician
  • Natchitoches, LA
  • NPI 1629023064
  NPD (past) Authorized official
• Ovayoza I Adeleye, MD

  • Psychiatry Physician
  • Natchitoches, LA
  • NPI 1538150263

  Pediatrics

  NPD

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1760545867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BIENVILLE ST",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575748",
            "telephone_number": "318-356-7211",
            "fax_number": "318-356-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BIENVILLE ST",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575748",
            "telephone_number": "318-356-7211",
            "fax_number": "318-356-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM CLINIC FOR CHILDREN APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2011-11-23",
        "status": "A",
        "authorized_official_last_name": "ADELEYE",
        "authorized_official_first_name": "OLUSEGUN",
        "authorized_official_middle_name": "ADEDAMOLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-356-7211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "200937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1949574",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kedrin O Seastrunk
• Allison K Self, PHARMD
• Tereneshia Session
• Stephanie Sewell
• Shalom Clinic for Children Apmc (Behavioral Health Services @Shalom Clinic for Children APMC)
• Jennifer Shaw
• Matthew Sheridan
• Jon Keller Shirley
• Carolyn Short
• SH'Kea Christine Sibley

• Pediatrics Physician in Natchitoches, LA
• Providers in Natchitoches, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.