NPIMap

Organization Active NPI

Northlake Eye Center, Apmc

  • Specialist
  • Slidell, LA
National Provider Identifier
1902019052
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
L023111 Issued in LA
Legal business name
NORTHLAKE EYE CENTER, APMC
Practice address
2243 Gause Blvd E
Slidell, LA 70461-4232
Phone
(985) 643-6355
Fax
(985) 643-0130
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Authorized official

Name
Dr. Terrell M Hemelt, M.D.NPI 1437177821
Title
President
Phone
(985) 643-6355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X L023111 LA Primary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X L014236 LA

Addresses

Primary practice location

2243 Gause Blvd E
Slidell, LA 70461-4232

Mailing address

2243 Gause Blvd E
Slidell, LA 70461-4232
Phone (985) 643-6355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101216000905 LA Part B Supplier - Clinic/Group Practice 3577751551 Receives reassigned benefits from 6 practitioners
Practice locations: Slidell, LA

National Provider Directory

National Provider Directory

Locations

2243 Gause Blvd E
Slidell, LA 70461
Phone (985) 643-6355

Practitioners & affiliated clinicians

Practitioners 6

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": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348012800000",
    "number": "1902019052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2243 GAUSE BLVD E",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704614232",
            "telephone_number": "985-643-6355",
            "fax_number": "985-643-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2243 GAUSE BLVD E",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704614232",
            "telephone_number": "985-643-6355",
            "fax_number": "985-643-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAKE EYE CENTER, APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2012-09-19",
        "status": "A",
        "authorized_official_last_name": "HEMELT",
        "authorized_official_first_name": "TERRELL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-643-6355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "L023111",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "L014236",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.