NPIMap

Organization Active NPI

Great Beginnings Pediatric & Adolescent Medicine, Apmc

  • Pediatrics Physician
  • Opelouas, LA
National Provider Identifier
1841343159
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
13641R Issued in LA
Legal business name
GREAT BEGINNINGS PEDIATRIC & ADOLESCENT MEDICINE, APMC
Practice address
3975 Interstate 49 S Service Rd
Ste 201
Opelouas, LA 70570-0775
Phone
(337) 407-2795
Fax
(337) 407-2798
NPI assigned
Jan 19, 2007
Last updated
Jul 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Authorized official

Name
Dr. Carmen Elizabeth Johnson, M.D.NPI 1003808346
Title
President
Phone
(337) 407-2795

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 13641R LA Primary

Addresses

Primary practice location

3975 Interstate 49 S Service Rd
Ste 201
Opelouas, LA 70570-0775

Mailing address

3975 Interstate 49 S Service Rd
Ste 201
Opelouas, LA 70570-0775
Phone (337) 407-2795

Other identifiers 1

IdentifierTypeStateIssuer
1449627MedicaidLA

National Provider Directory

National Provider Directory

Locations

3975 I 49 S Service Rd
Ste 201
Opelousas, LA 70570
Phone (337) 407-2795

Practitioners & affiliated clinicians

Practitioners 5

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": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405296000000",
    "number": "1841343159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 INTERSTATE 49 S SERVICE RD",
            "address_2": "STE 201",
            "city": "OPELOUAS",
            "state": "LA",
            "postal_code": "705700775",
            "telephone_number": "337-407-2795",
            "fax_number": "337-407-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 INTERSTATE 49 S SERVICE RD",
            "address_2": "STE 201",
            "city": "OPELOUAS",
            "state": "LA",
            "postal_code": "705700775",
            "telephone_number": "337-407-2795",
            "fax_number": "337-407-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT BEGINNINGS PEDIATRIC & ADOLESCENT MEDICINE, APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2014-07-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-407-2795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "13641R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1449627",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.