Active NPI
Our Clinic, Inc
- Adult Medicine Physician
- New Orleans, LA
National Provider Identifier
1962673459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- MD.06513R
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1344681 | Medicaid | LA |
National Provider Directory
National Provider DirectoryLocations
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.