NPIMap

Organization Active NPI

Patrick C Hagen Ear, Nose, Throat & Sinus Clinic

  • Otolaryngology Physician
  • Thibodaux, LA
National Provider Identifier
1871630236
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
PATRICK C HAGEN EAR, NOSE, THROAT & SINUS CLINIC
Practice address
2000 Audubon Ave
Suite C
Thibodaux, LA 70301-5075
Phone
(985) 446-1200
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Authorized official

Name
Celeste Ponvelle
Title
Administrator
Phone
(800) 639-2519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

2000 Audubon Ave
Suite C
Thibodaux, LA 70301-5075

Mailing address

PO Box 146
Thibodaux, LA 70302-0146
Phone (800) 639-2519

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1871630236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 146",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703020146",
            "telephone_number": "800-639-2519",
            "fax_number": "985-447-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 AUDUBON AVE",
            "address_2": "SUITE C",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015075",
            "telephone_number": "985-446-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK C HAGEN EAR, NOSE, THROAT & SINUS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "PONVELLE",
        "authorized_official_first_name": "CELESTE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "800-639-2519"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.