Louisiana State University Health Sciences Center

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER

Practice address

1541 Kings Hwy
Lsu Histo Immunology Diagnostic Lab
Shreveport, LA 71103-4228

Phone

(318) 675-5000

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Melanie H Sotak, MHSA

Title

Director of Managed Care

Phone

(318) 675-7737

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• LSUHSC-S Histo Immunology Diganostic Lab Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Louisiana State University Health Sciences Center

  • Clinical Medical Laboratory
  • Shreveport, LA
  • NPI 1336762269

  O20071217000569

  Same enrollment

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Louisiana State University Health Sciences Center

  • Anatomic Pathology & Clinical Pathology Physician
  • Shreveport, LA
  • NPI 1326117003

  Member Of

  NPD member
• Louisiana State University Health Sciences Center

  • Nephrology Physician
  • Shreveport, LA
  • NPI 1649438532

  Member Of

  NPD member

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1891863403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "address_2": "LSU HISTO IMMUNOLOGY DIAGNOSTIC LAB",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "address_2": "LSU HISTO IMMUNOLOGY DIAGNOSTIC LAB",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "SOTAK",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "318-675-7737",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1323861",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LSUHSC-S Histo Immunology Diganostic Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Louisiana State University Health Sciences Center
• Louisiana State University Health Sciences Center
• Louisiana State University Health Sciences Center
• Louisiana State University Health Sciences Center
• Louisiana State University Health Sciences Center
• Louisiana State University Health Sciences Center
• Louisiana State University Health Sciences Center
• Louisiana State University Health Sciences Center Shreveport
• Louisiana State University Health Sciences Center Shreveport
• Louisiana State University Health Sciences Center Viral Disease Clini

• Clinical Medical Laboratory in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Clinical Medical Laboratory in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; 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.