Organization Active NPI

Beauregard Hematolog & Oncology

  • Internal Medicine Physician
  • Deridder, LA
National Provider Identifier
1821419334
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD206603 Issued in LA
Legal business name
BEAUREGARD HEMATOLOG & ONCOLOGY
Practice address
301 S. Washington St.
Ste B
Deridder, LA 70634
Phone
(337) 463-4777
Fax
(337) 463-4770
NPI assigned
Dec 31, 2013
Last updated
Dec 31, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
BEAUREGARD HEMATOLOGY & ONCOLOGYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Authorized official

Name
Nancy G. Kennedy, PRACTICE MANAGER
Title
Practice Manager
Phone
(337) 463-4777

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD206603 LA Primary
Hematology & Oncology Physician 207RH0003X MD206603 LA

Addresses

Primary practice location

301 S. Washington St.
Ste B
Deridder, LA 70634

Mailing address

301 S. Washington St.
Ste B
Deridder, LA 70634
Phone (337) 463-4777

National Provider Directory

National Provider Directory
Part of
Beauregard Hematology Onco

Locations

301 S Washington St
#B
Deridder, LA 70634
Phone (337) 460-7688

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1388448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388448000000",
    "number": "1821419334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S. WASHINGTON ST.",
            "address_2": "STE B",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "70634",
            "telephone_number": "337-463-4777",
            "fax_number": "337-463-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S. WASHINGTON ST.",
            "address_2": "STE B",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "70634",
            "telephone_number": "337-463-4777",
            "fax_number": "337-463-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUREGARD HEMATOLOG & ONCOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEAUREGARD HEMATOLOGY & ONCOLOGY",
        "enumeration_date": "2013-12-31",
        "last_updated": "2013-12-31",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "337-463-4777",
        "authorized_official_credential": "PRACTICE MANAGER"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD206603",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "LA",
            "license": "MD206603",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; 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.