Individual provider Active NPI

Carol A. Luttrell, MD

  • Diagnostic Radiology Physician
  • Metairie, LA
National Provider Identifier
1871598474
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
10832R Issued in LA
Practice address
4200 Houma Blvd
Metairie, LA 70006-2970
Phone
(504) 454-4133
Fax
(504) 456-8125
NPI assigned
Jun 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 10832R LA Primary
Diagnostic Radiology Physician 2085R0202X MD17514 RI

Addresses

Primary practice location

4200 Houma Blvd
Metairie, LA 70006-2970

Mailing address

PO Box 8090
Metairie, LA 70011-8090
Phone (504) 454-4133

Other practice location 1

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone (401) 921-9202

Other identifiers 1

IdentifierTypeStateIssuer
1698032MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020000687 LA Practitioner - Diagnostic Radiology 9739140013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Virginia Commonwealth University, School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Radiology, LLCGroup PAC ID 2860404811, 40 clinicians

Practice addresses (Care Compare)

1202 S Tyler St
Covington, LA 70433-2330
Phone (985) 898-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10832RLAMDDiagnostic Radiology Physician
MD17514RIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Radiology, LLC Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients
Lafayette Health Ventures, Inc Past Accepting new patients
Administrators of the Tulane Education Fund PastSince Jul 31, 2023 Accepting new patients
Louisiana Anesthesiology Group, L.L.C. Past Accepting new patients

Locations

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

16282 Highway 1085
Covington, LA 70433
Phone (985) 898-4140

82525 Highway 25
Folsom, LA 70437
Phone (985) 839-9895

1322 Elton Rd
Ste F
Jennings, LA 70546
Phone (337) 824-8868

409 W Pont des Mouton Rd
Lafayette, LA 70507

1401 Foucher St
New Orleans, LA 70115
Phone (504) 897-7011

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1871598474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8090",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700118090",
            "telephone_number": "504-454-4133",
            "fax_number": "504-456-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062970",
            "telephone_number": "504-454-4133",
            "fax_number": "504-456-8125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Metro Center Blvd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028861785",
            "country_code": "US",
            "telephone_number": "401-921-9202",
            "fax_number": "401-921-9212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTTRELL",
        "first_name": "CAROL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "10832R",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD17514",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1698032",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.