Active NPI
Lsumc-S Family Practice Medical
- Family Medicine Physician
- Alexandria, LA
National Provider Identifier
1992888101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- LSUMC-S FAMILY PRACTICE MEDICAL
- Practice address
- 301 4TH St Ste a
Alexandria, LA 71301-8411 - Phone
- (318) 441-1030
- Fax
- (318) 441-1050
- NPI assigned
- Oct 23, 2006
- 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
- Leisa P Oglesby
- Title
- Executive Dir for Medical Services
- Phone
- (318) 675-7629
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
301 4TH St Ste a
Alexandria, LA 71301-8411
Mailing address
PO Box 735328
Dallas, TX 75373-5328
Phone (318) 441-1030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1948705 | Medicaid | LA |
Other names 1
- LSUHSC-S Family Medicine Residency Program
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031222000187 | LA | Part B Supplier - Clinic/Group Practice | 7719885367 |
Receives reassigned benefits from 14 practitioners Practice locations: Alexandria, LA |
National Provider Directory
National Provider Directory- Tax ID family
- Lsuhsc-S Family Medicine Residency Program
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Family Medicine Physician
- Alexandria, LA
- NPI 1942889852
Locations
821 Elliott St
Alexandria, LA 71301
Phone (318) 441-1030
301 4th St
#A
Alexandria, LA 71301
Practitioners & affiliated clinicians
Practitioners 23
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Lecompte, LA
- NPI 1184627838
Family Medicine, LA
-
- Sports Medicine (Family Medicine) Physician
- Shreveport, LA
- NPI 1457889602
Family Medicine, LA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1617753600000",
"number": "1992888101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735328",
"city": "DALLAS",
"state": "TX",
"postal_code": "753735328",
"telephone_number": "318-441-1030",
"fax_number": "318-441-1050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 4TH ST STE A",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713018411",
"telephone_number": "318-441-1030",
"fax_number": "318-441-1050"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LSUMC-S FAMILY PRACTICE MEDICAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-23",
"last_updated": "2021-04-07",
"certification_date": "2021-04-07",
"status": "A",
"authorized_official_last_name": "OGLESBY",
"authorized_official_first_name": "LEISA",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "EXECUTIVE DIR FOR MEDICAL SERVICES",
"authorized_official_telephone_number": "318-675-7629"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1948705",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LSUHSC-S Family Medicine Residency Program",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "LSUHSC-S Family Medicine Residency Program",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Alexandria, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.