Crescent City Surgical Centre Diagnostics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CRESCENT CITY SURGICAL CENTRE DIAGNOSTICS, LLC

Practice address

2805 W Mall Dr
Florence, AL 35630-1563

Phone

(504) 766-9882

Fax

(504) 504-5211

NPI assigned

Jun 5, 2025

Organization subpart

No

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

Authorized official

Name

William Lawrence Bouchillon

Title

Practice Manager

Phone

(504) 766-9882

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Crescent City Surgical Centre Diagnostics, LLC

  • Clinical Medical Laboratory
  • Metairie, LA
  • NPI 1942807425

  3072981315

  Same PAC ID

Tax ID family

Crescent City Surgical Centre Diagnostics LLC3 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.

• Crescent City Surgical Centre Diagnostics, LLC

  • Clinical Medical Laboratory
  • Kosciusko, MS
  • NPI 1598687717
  NPD tax ID
• Crescent City Surgical Centre Diagnostics, LLC

  • Clinical Medical Laboratory
  • Metairie, LA
  • NPI 1942807425
  NPD tax ID

Locations

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1790679512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 W MALL DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301563",
            "telephone_number": "504-766-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 W MALL DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301563",
            "telephone_number": "504-766-9882",
            "fax_number": "504-504-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT CITY SURGICAL CENTRE DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "BOUCHILLON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "504-766-9882"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Crawford
• Paul Allen Crawford, ATC
• Brandi N Creel, APN-C
• Larry Kevin Creel, CRNA
• Erika Wunderlich Crenshaw, MD
• Homer James Crittenden Jr.
• Miranda Lee Crittenden, RN
• Carson Myles Cruise, DMD
• Curt Abercrombie PC
• Jake Michael Curtis

• Clinical Medical Laboratory in Florence, AL
• Providers in Florence, AL by specialty
• Clinical Medical Laboratory in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.