Organization Active NPI

Bluebonnet Imaging Center, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Baton Rouge, LA
National Provider Identifier
1942393699
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
BLUEBONNET IMAGING CENTER, LLC
Practice address
4570 Bluebonnet Blvd.
Suite B
Baton Rouge, LA 70809
Phone
(225) 298-3223
Fax
(225) 298-5474
NPI assigned
Oct 2, 2006
Last updated
Oct 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
John P Stagg
Title
Ceo
Phone
(225) 270-7077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary

Addresses

Primary practice location

4570 Bluebonnet Blvd.
Suite B
Baton Rouge, LA 70809

Mailing address

4241 Veterans Memorial Blvd Ste 200
Metairie, LA 70006-5430
Phone (504) 459-3220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070710000949 LA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3779683461 Practice locations: Baton Rouge, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1081861Bluebonnet Imaging Center4570 Bluebonnet Boulevard Suite B, Baton Rouge, LA 70809Certificate of waiverMar 26, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4570 Bluebonnet Blvd
Ste A
Baton Rouge, LA 70809
Phone (225) 767-8550

Practitioners & affiliated clinicians

Practitioners 60

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.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1942393699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 VETERANS MEMORIAL BLVD STE 200",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700065430",
            "telephone_number": "504-459-3220",
            "fax_number": "504-883-5384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 BLUEBONNET BLVD.",
            "address_2": "SUITE B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70809",
            "telephone_number": "225-298-3223",
            "fax_number": "225-298-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBONNET IMAGING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "STAGG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-270-7077"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.