NPIMap

Organization Active NPI

West Jefferson MRI, LLC

Doing business as MRI of Louisiana

  • Physiological Laboratory
  • Marrero, LA
National Provider Identifier
1952302929
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
WEST JEFFERSON MRI, LLC
Doing business as
MRI of Louisiana
Practice address
1111 Medical Center Blvd
Suite N-110
Marrero, LA 70072-3151
Phone
(504) 349-6570
Fax
(504) 934-8040
NPI assigned
Aug 2, 2005
Last updated
Sep 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Authorized official

Name
Mr. Patrick G. Howard
Title
Managing Member
Phone
(337) 291-9161

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

1111 Medical Center Blvd
Suite N-110
Marrero, LA 70072-3151

Mailing address

1111 Medical Center Blvd
Suite N-110
Marrero, LA 70072-3151
Phone (504) 349-6570

Other identifiers 1

IdentifierTypeStateIssuer
1442607MedicaidLA

Other names 1

  • MRI of Louisiana Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050309000205 LA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8224082623 Practice locations: Marrero, LA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
19D0999491West Jefferson Women's Health1111 Medical Center Boulevard, Ste 250 South, Marrero, LA 70072Certificate of waiverSep 30, 2026
19D1061612West Jefferson Urology Specialists1111 Medical Center Blvd, North Tower, Suite 703, Marrero, LA 70072Provider-performed microscopyNov 20, 2026
19D2020568West Jefferson Holdings, LLC1111 Medical Center Blvd, Suite S-750 & S-650, Marrero, LA 70072Certificate of waiverJun 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
West Jefferson MRI LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Locations

1111 Medical Center Blvd
Ste N110
Marrero, LA 70072
Phone (504) 349-6191

1111 Medical Center Blvd
Ste N118
Marrero, LA 70072
Phone (504) 349-1461

4525 Westbank Expy
Ste B
Marrero, LA 70072
Phone (504) 349-6570

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1952302929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE N-110",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6570",
            "fax_number": "504-934-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE N-110",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6570",
            "fax_number": "504-934-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST JEFFERSON MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "337-291-9161",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1442607",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MRI of Louisiana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.