Roland S. Waguespack MD Apmc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

009974 Issued in LA

Legal business name

ROLAND S. WAGUESPACK MD APMC

Doing business as

St. Philip Clinic

Practice address

1108 Saint James St
Vacherie, LA 70090-5320

Phone

(225) 265-4087

Fax

(225) 265-4006

NPI assigned

Dec 19, 2006

Last updated

Jan 19, 2010By 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. Roland S. Waguespack, M.D.NPI 1013983295

Title

M.D.

Phone

(225) 265-4087

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• ST. PHILIP CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Tax ID family

Roland S Waguespack MD3 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.

• Roland S Waguespack MD

  dba St Philip Clinic

  • Pharmacy
  • Vacherie, LA
  • NPI 1790906766
  NPD tax ID
• Roland S. Waguespack MD

  dba St. Philip Clinic

  • Clinic Pharmacy
  • Vacherie, LA
  • NPI 1215141098
  NPD tax ID

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.

• Roland S Waguespack Jr., MD

  • Family Medicine Physician
  • Vacherie, LA
  • NPI 1013983295
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1801959929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 SAINT JAMES STREET",
            "city": "VACHERIE",
            "state": "LA",
            "postal_code": "70090",
            "telephone_number": "225-265-4087",
            "fax_number": "225-265-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 SAINT JAMES ST",
            "city": "VACHERIE",
            "state": "LA",
            "postal_code": "700905320",
            "telephone_number": "225-265-4087",
            "fax_number": "225-265-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLAND S. WAGUESPACK MD APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "WAGUESPACK",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "225-265-4087",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "LA",
            "license": "203080",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "LA",
            "license": "009974",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "23919",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1442224",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. PHILIP CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kiersten Rapp, PHARMD
• Reni O, LLC
• Madison Ann Robichaux
• Roland S Waguespack MD (St Philip Clinic)
• Roland S. Waguespack MD (St. Philip Clinic)
• Sarat K Donepudi MD Apmc
• St James Arc (Vacherie Day Development Training Center)
• St James Arc (Vacherie Day Developmental Training Center)
• St James Parish Hosp Serv Dist (SJPH Physician Clinics)
• St James Parish Hosp. Serv. Dist. (St. James West Bank Clinic)

• Primary Care Clinic/Center in Vacherie, LA
• Providers in Vacherie, LA by specialty
• Primary Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; 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.