NPIMap

Organization Active NPI

Bluebonnet Family Clinic, LLC

  • Primary Care Clinic/Center
  • Baton Rouge, LA
National Provider Identifier
1932397882
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
022386 Issued in LA
Legal business name
BLUEBONNET FAMILY CLINIC, LLC
Practice address
9241 Bluebonnet Blvd
Suite B
Baton Rouge, LA 70810-2808
Phone
(225) 757-6031
Fax
(225) 757-6035
NPI assigned
Oct 4, 2007
Last updated
Oct 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Authorized official

Name
Marykutty J Thomas, M.D.NPI 1477552156
Title
Owner
Phone
(225) 757-6031

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 022386 LA Primary

Addresses

Primary practice location

9241 Bluebonnet Blvd
Suite B
Baton Rouge, LA 70810-2808

Mailing address

9241 Bluebonnet Blvd
Suite B
Baton Rouge, LA 70810-2808
Phone (225) 757-6031

Other identifiers 1

IdentifierTypeStateIssuer
1676471MedicaidLA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1932397882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9241 BLUEBONNET BLVD",
            "address_2": "SUITE B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708102808",
            "telephone_number": "225-757-6031",
            "fax_number": "225-757-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9241 BLUEBONNET BLVD",
            "address_2": "SUITE B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708102808",
            "telephone_number": "225-757-6031",
            "fax_number": "225-757-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBONNET FAMILY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MARYKUTTY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-757-6031",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "LA",
            "license": "022386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1676471",
            "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 Oct 4, 2007; 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.