Patrick Edward Mottram, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD.03279R Issued in LA

Practice address

1100 E Judge Perez Dr
Chalmette, LA 70043-5405

Phone

(504) 333-6988

Fax

(504) 342-2184

NPI assigned

Mar 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Img Physicians,LLC

  • Internal Medicine Physician
  • Covington, LA
  • NPI 1033157441
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1962471177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 OAK HARBOR BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704585702",
            "telephone_number": "985-726-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E JUDGE PEREZ DR",
            "city": "CHALMETTE",
            "state": "LA",
            "postal_code": "700435405",
            "telephone_number": "504-333-6988",
            "fax_number": "504-342-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTTRAM",
        "first_name": "PATRICK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.03279R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1128279",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jimani Sadiyah Montrell
• Brittamy Moore
• Cathy E Moore
• Matthew Morgan, M.D.
• Motion Dynamics Physical Therapy
• Dennis J Muller, O.D.
• Megan Murphy, PTA
• My Suite Dream, LLC
• Alisha S. Nettles
• Neutral Ground Counseling LLC

• Internal Medicine Physician in Chalmette, LA
• Providers in Chalmette, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.