Northlake Surgical Associates, LTD a Professional Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

NORTHLAKE SURGICAL ASSOCIATES, LTD A PROFESSIONAL MEDICAL CORPORATION

Practice address

606 W 11TH Ave
Covington, LA 70433-3630

Phone

(985) 892-3766

Fax

(985) 893-9567

NPI assigned

Mar 2, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Sabrina W Hebert

Title

Office Manager

Phone

(985) 892-3766

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Karl Ordoyne Jr.

  • Surgery Physician
  • Covington, LA
  • NPI 1710988951
  NPD
• Philip A Gardner, MD

  • Vascular Surgery Physician
  • Covington, LA
  • NPI 1952375487
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1962531483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704340128",
            "telephone_number": "985-892-3766",
            "fax_number": "985-893-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 W 11TH AVE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704333630",
            "telephone_number": "985-892-3766",
            "fax_number": "985-893-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAKE SURGICAL ASSOCIATES, LTD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "985-892-3766",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1791873",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northlake Nephrology Inc
• Northlake Nephrology Physicians Group LLC
• Northlake Neurorehab Center
• Northlake Pharmacy Inc
• Northlake Pulmonary Associates Inc.
• Northland Hearing Centers, Inc.
• Northshore Behavioral Health, LLC
• Northshore Counseling and Wellness LLC
• Northshore Family Medicine, LLC
• Northshore Family Resource Center LLC

• All providers in Covington, LA
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.