NPIMap

Organization Active NPI

Southeastern Louisiana Univerisity

Doing business as SLU Sports Medicine

  • Family Medicine Physician
  • Hammond, LA
National Provider Identifier
1780075499
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTHEASTERN LOUISIANA UNIVERISITY
Doing business as
SLU Sports Medicine
Practice address
800 Galloway Dr
Dugas Center
Hammond, LA 70402-0001
Phone
(985) 549-5133
Fax
(972) 367-3451
NPI assigned
Feb 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Authorized official

Name
John Irwin
Title
Asst. Director for Sports Medicine
Phone
(985) 549-5133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

800 Galloway Dr
Dugas Center
Hammond, LA 70402-0001

Mailing address

PO Box 650850
Dept. 1011
Dallas, TX 75265-0850
Phone (800) 555-9073

Other names 1

  • SLU Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Slu Sports Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

800 Galloway St
Hammond, LA 70402
Phone (985) 549-2253

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1780075499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650850",
            "address_2": "DEPT. 1011",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650850",
            "telephone_number": "800-555-9073",
            "fax_number": "972-367-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GALLOWAY DR",
            "address_2": "DUGAS CENTER",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704020001",
            "telephone_number": "985-549-5133",
            "fax_number": "972-367-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN LOUISIANA UNIVERISITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "IRWIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ASST. DIRECTOR FOR SPORTS MEDICINE",
        "authorized_official_telephone_number": "985-549-5133"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SLU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hammond, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.