Organization Active NPI

Louisiana Brain & Spine Clinic, II,LLP

  • Specialist
  • Thibodaux, LA
National Provider Identifier
1790845287
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
LOUISIANA BRAIN & SPINE CLINIC, II,LLP
Practice address
604 N Acadia Rd
Suite 410
Thibodaux, LA 70301-4847
Phone
(985) 447-2645
Fax
(985) 447-2604
NPI assigned
Dec 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Sherry V Fontenot
Title
Manager
Phone
(985) 447-2645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

604 N Acadia Rd
Suite 410
Thibodaux, LA 70301-4847

Mailing address

604 N Acadia Rd
Suite 410
Thibodaux, LA 70301-4847
Phone (985) 447-2645

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790845287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N ACADIA RD",
            "address_2": "SUITE 410",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014847",
            "telephone_number": "985-447-2645",
            "fax_number": "985-447-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N ACADIA RD",
            "address_2": "SUITE 410",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014847",
            "telephone_number": "985-447-2645",
            "fax_number": "985-447-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA BRAIN & SPINE CLINIC, II,LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONTENOT",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "985-447-2645",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.