Organization Active NPI

Our Clinic, Inc

  • Adult Medicine Physician
  • New Orleans, LA
National Provider Identifier
1962673459
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
MD.06513R Issued in LA
Legal business name
OUR CLINIC, INC
Practice address
4301 Elysian Fields Ave
New Orleans, LA 70122-3875
Phone
(504) 284-3866
Fax
(504) 284-3869
NPI assigned
Mar 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Authorized official

Name
Mrs. Rose A Holmes
Title
Manager
Phone
(713) 451-5320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X MD.06513R LA Primary

Addresses

Primary practice location

4301 Elysian Fields Ave
New Orleans, LA 70122-3875

Mailing address

40189 Pelican Point Pkwy
Gonzales, LA 70737-8501
Phone (504) 491-3124

Other identifiers 1

IdentifierTypeStateIssuer
1344681MedicaidLA

National Provider Directory

National Provider Directory

Locations

10555 Lake Forest Blvd
Ste 3N
New Orleans, LA 70127
Phone (504) 245-1487

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1962673459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40189 PELICAN POINT PKWY",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707378501",
            "telephone_number": "504-491-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 ELYSIAN FIELDS AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701223875",
            "telephone_number": "504-284-3866",
            "fax_number": "504-284-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "713-451-5320",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "LA",
            "license": "MD.06513R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1344681",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.