NRMC Physician Ipa Inc
Organization Active NPI Obstetrics & Gynecology Physician · Natchitoches, LA
NPI 1922568039 · NPPES record last updated Jun 26, 2020
Key facts
- NPI
- 1922568039
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- Legal business name
- NRMC PHYSICIAN IPA INC
- Practice address
- 655 Bienville Cir
Natchitoches, LA 71457-5744 - Phone
- (318) 238-3652
- Fax
- (318) 238-3654
- NPI assigned
- Mar 24, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- NRMC PHYSICIAN IPA INC
Authorized official
- Name
- William Bradford McCormick
- Title
- Cfo
- Phone
- (318) 214-4350
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 7
Practitioners 16
-
Keith M Ashby, MD
-
Charli Cox, APRN
-
Sandhya Charlotte Thomas, FNP-C APRN
-
Martin Aviles, M.D.
-
Willliam A Ball Jr., M.D.
-
Dana Bennett, APRN
-
Steven Michael Jackson, D.O.
-
Lounida Johnson, FNP
-
Megan Lee, PA
-
Phyllis Lynnette Mason, M.D.
-
Barbara W McCoy, MIDWIFE, WHNP
-
Moshood Olatinwo, MD
-
Amanda Roberts, RD, LDN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170808001651 | LA | Part B Supplier - Clinic/Group Practice | 9234400300 |
Receives reassigned benefits from 44 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Natchitoches, LA |
National Provider Directory
- Part of
- NRMC Physician Ipa Inc
Locations
740 Keyser Ave
Ste D
Natchitoches, LA 71457
Phone (318) 354-2555
601 Keyser Ave
Natchitoches, LA 71457
Phone (318) 214-4200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | Yes |
Addresses
Primary practice location
655 Bienville Cir
Natchitoches, LA 71457-5744
Mailing address
PO Box 2475
Natchitoches, LA 71457-2475
Other names
- NRMC OB/GYN ASSOCIATES
Other providers in Natchitoches, LA
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Physician Ipa Inc
- NRMC Walk-in Clinic Ventures, LLC
- Fallon Dai O'Bannon
- Oladele Oladiran
- Moshood Olatinwo
All providers in Natchitoches, LA · Obstetrics & Gynecology Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.