NPIMap

Organization Active NPI

Our Lady of Lourdes Regional Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
National Provider Identifier
1952497489
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC
Practice address
4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone
(337) 470-2100
Fax
(337) 470-2574
NPI assigned
Oct 4, 2006
Last updated
Nov 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Authorized official

Name
William Bryan Lee
Title
Ceo
Phone
(337) 470-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917

Mailing address

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2100

Other identifiers 1

IdentifierTypeStateIssuer
1443468MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305000956 LA Part B Supplier - Clinic/Group Practice 5890683411 Receives reassigned benefits from 28 practitioners
Practice locations: Lafayette, LA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Member organizations 24

Organizations listed as members of this organization in the National Provider Directory.

View all 24

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Park Place Surgery Center LLCLafayette, LA, CCN 190255 Hospital 5% Or Greater Direct Ownership Interest (50.01%)
Operational/Managerial Control		 Jan 10, 2006
Jan 2, 2013
Lourdes Home HealthLafayette, LA, CCN 197057 Home health agency 5% Or Greater Direct Ownership Interest (33%) Jul 1, 2007

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542585600000",
    "number": "1952497489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086917",
            "telephone_number": "337-470-2100",
            "fax_number": "337-470-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086917",
            "telephone_number": "337-470-2100",
            "fax_number": "337-470-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2018-11-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-470-2100"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1443468",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.