Louisiana Medicine and Geratrics Associates

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

L12718R Issued in LA

Legal business name

LOUISIANA MEDICINE AND GERATRICS ASSOCIATES

Practice address

1503 Stubbs Ave
Monroe, LA 71201-5627

Phone

(318) 388-0440

Fax

(318) 388-0330

NPI assigned

Mar 21, 2007

Last updated

Aug 22, 2020By 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. Sunil Prem, M.D.NPI 1417038746

Title

President

Phone

(318) 388-0440

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

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.

• Sunil Prem, M.D.

  • Internal Medicine Physician
  • Monroe, LA
  • NPI 1417038746

  Geriatric Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861518185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 STUBBS AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015627",
            "telephone_number": "318-388-0440",
            "fax_number": "318-388-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 STUBBS AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015627",
            "telephone_number": "318-388-0440",
            "fax_number": "318-388-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA MEDICINE AND GERATRICS ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PREM",
        "authorized_official_first_name": "SUNIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-388-0440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "LA",
            "license": "L12718R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1542555",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Internal Medicine) Physician in Monroe, LA
• Providers in Monroe, LA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.