NPIMap

Organization Active NPI

Mayo Medical Clinic

  • Primary Care Clinic/Center
  • Baton Rouge, LA
National Provider Identifier
1902095987
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
023611 Issued in LA
Legal business name
MAYO MEDICAL CLINIC
Practice address
3401 North Blvd
Suite 360
Baton Rouge, LA 70806-3743
Phone
(225) 381-2712
NPI assigned
Oct 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Authorized official

Name
Dr. Tamika Mayo, M.D.
Title
Medical Doctor
Phone
(225) 381-2712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 023611 LA Primary

Addresses

Primary practice location

3401 North Blvd
Suite 360
Baton Rouge, LA 70806-3743

Mailing address

3401 North Blvd
Suite 410
Baton Rouge, LA 70806-3743
Phone (225) 381-2712

Other identifiers 1

IdentifierTypeStateIssuer
1576565MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1902095987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 NORTH BLVD",
            "address_2": "SUITE 410",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063743",
            "telephone_number": "225-381-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 NORTH BLVD",
            "address_2": "SUITE 360",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063743",
            "telephone_number": "225-381-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "TAMIKA",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "225-381-2712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "LA",
            "license": "023611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1576565",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; 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.