NPIMap

Organization Active NPI

Beauregard Pediatric Center, LLC

  • Pediatrics Physician
  • Deridder, LA
National Provider Identifier
1992005532
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BEAUREGARD PEDIATRIC CENTER, LLC
Practice address
600 S Pine St
Deridder, LA 70634-4942
Phone
(337) 462-7106
Fax
(337) 462-7479
NPI assigned
Oct 29, 2010
Organization subpart
Yes
Parent organization
WEST LOUISIANA HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

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

Authorized official

Name
Mr. Theodore J. Badger Jr.
Title
Ceo
Phone
(337) 462-7105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

600 S Pine St
Deridder, LA 70634-4942

Mailing address

PO Box 730
Deridder, LA 70634-0730
Phone (337) 462-7106

National Provider Directory

National Provider Directory
Part of
Beauregard Memorial Hospital Medical Staff Services

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1992005532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706340730",
            "telephone_number": "337-462-7106",
            "fax_number": "337-462-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344942",
            "telephone_number": "337-462-7106",
            "fax_number": "337-462-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUREGARD PEDIATRIC CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST LOUISIANA HEALTH SERVICES, INC.",
        "enumeration_date": "2010-10-29",
        "last_updated": "2010-10-29",
        "status": "A",
        "authorized_official_last_name": "BADGER",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-462-7105",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.