NPIMap

Organization Active NPI

St. James Primary Care

  • Family Medicine Physician
  • Donaldsonville, LA
National Provider Identifier
1841521200
Registry record updated Apr 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
203358 Issued in LA
Legal business name
ST. JAMES PRIMARY CARE
Practice address
106 Memorial Dr
Donaldsonville, LA 70346-4337
Phone
(225) 473-0000
NPI assigned
Jan 26, 2010
Last updated
Apr 19, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. JAMES PRIMARY CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 19, 2010

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

Authorized official

Name
Anu P Vellanki, MDNPI 1497746499
Title
Owner
Phone
(225) 907-3220

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 203358 LA Primary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 12855R LA

Addresses

Primary practice location

106 Memorial Dr
Donaldsonville, LA 70346-4337

Mailing address

PO Box 419
Gramercy, LA 70052-0419
Phone (225) 869-9200

Other identifiers 2

IdentifierTypeStateIssuer
1822141MedicaidLA
6650933750OtherLABLUE CROSS

Other names 1

  • St. James Primary Care, Donaldsonville Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040728000368 LA Part B Supplier - Clinic/Group Practice 0941270961 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gramercy, LA
O20100324001059 LA Part B Supplier - Clinic/Group Practice 0941270961 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gramercy, LA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
St James Primary Care

Locations

106 Memorial Dr
Donaldsonville, LA 70346
Phone (225) 257-4453

Practitioners & affiliated clinicians

Practitioners 11

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": "1264464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271635200000",
    "number": "1841521200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "city": "GRAMERCY",
            "state": "LA",
            "postal_code": "700520419",
            "telephone_number": "225-869-9200",
            "fax_number": "225-869-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MEMORIAL DR",
            "city": "DONALDSONVILLE",
            "state": "LA",
            "postal_code": "703464337",
            "telephone_number": "225-473-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JAMES PRIMARY CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JAMES PRIMARY CARE",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-04-19",
        "status": "A",
        "authorized_official_last_name": "VELLANKI",
        "authorized_official_first_name": "ANU",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-907-3220",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "203358",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "12855R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1822141",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "6650933750",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. James Primary Care, Donaldsonville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Donaldsonville, LA

Sources for this page

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