Bayou Physical Medicine, Inc.

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

MD.15662R Issued in LA

Legal business name

BAYOU PHYSICAL MEDICINE, INC.

Practice address

12038 Lake Sherwood Ave N
Baton Rouge, LA 70816-4341

Phone

(225) 247-6483

NPI assigned

May 11, 2009

Last updated

Oct 13, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Elsie M Colin, MD

Title

President/Ceo

Phone

(225) 247-6483

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255392000000",
    "number": "1962636597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64800",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708964800",
            "telephone_number": "225-247-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12038 LAKE SHERWOOD AVE N",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164341",
            "telephone_number": "225-247-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYOU PHYSICAL MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-11",
        "last_updated": "2009-10-13",
        "status": "A",
        "authorized_official_last_name": "COLIN",
        "authorized_official_first_name": "ELSIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "225-247-6483",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "LA",
            "license": "MD.15662R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; 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.