Northshore ENT Clinic, LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

NORTHSHORE ENT CLINIC, LLC

Practice address

42401 Pelican Professional Park
Hammond, LA 70403-2405

Phone

(985) 542-9155

Fax

(985) 542-9133

NPI assigned

Jul 19, 2005

Organization subpart

No

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

Authorized official

Name

Nancy R. Mellin, M.D.NPI 1255330494

Title

Owner

Phone

(985) 542-9155

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Nancy R. Mellin, M.D.

  • Sleep Medicine (Otolaryngology) Physician
  • Hammond, LA
  • NPI 1255330494
  NPD Authorized official

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1811996069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42401 PELICAN PROFESSIONAL PARK",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704032405",
            "telephone_number": "985-542-9155",
            "fax_number": "985-542-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42401 PELICAN PROFESSIONAL PARK",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704032405",
            "telephone_number": "985-542-9155",
            "fax_number": "985-542-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE ENT CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "MELLIN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-542-9155",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1449407",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northland Hearing Centers Inc
• Northland Hearing Centers, Inc.
• Northshore Ambulatory Surgery Center LLC
• Northshore Anesthesia, LLC
• Northshore Counseling Group LLC
• Northshore Eye Associates LLC
• Northshore Hospital Medicine LLC
• Northshore Imaging Assoc LLC
• Northshore Internal Medicine Associates
• Northshore Provider Group LLC

• Otolaryngology Physician in Hammond, LA
• Providers in Hammond, LA by specialty
• Otolaryngology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.