IMAGING CENTER OF SOUTH LOUISIANA, LLC (NPI# 1083610364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083610364 |
| Entity Type | Organization |
| Organization Name | IMAGING CENTER OF SOUTH LOUISIANA, LLC |
| Practice Address |
114 Neuroscience Court Gray LA 70359 |
| Mailing Address |
P.o. Box 1047 Gray LA 70359 |
| Practice Telephone | 9855802888 |
| Practice Fax Number | 9858517526 |
| Mailing Telephone | 9855802888 |
| Mailing Fax Number | 9858512786 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2016-02-03 |
| Authorized Official Name | DR. DONALD SEVERINUS GERVAIS (MANAGING MEMBER) |
| Authorized Official Telephone | 9858506805 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHEAST NEUROSCIENCE CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1443212 | 05 |
| Street Address |
114 NEUROSCIENCE COURT |
| City | GRAY |
| State | LA |
| Zip Code | 70359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734785 | Cardiovascular Institute of The South Asc, LLC | Clinic/Center | 191 Innovation Court, Gray, LA 70359 | 2020-06-09 |
| 1265985915 | Gavin Triche | Physician Assistant | 128 Neuroscience Court, Gray, LA 70359 | 2016-07-29 |
| 1992939367 | Donna Marie Pugh | Health Maintenance Organization | 216 Champion St, Gray, LA 70359 | 2009-05-13 |
| 1700877297 | Ultrasound Enterprise LLC | Radiology | 165 Frontage Road, Suite B, Gray, LA 70359 | 2005-11-02 |
| 1285630129 | Southeast Neuroscience Center, LLC | Specialist | 128 Neuroscience Ct, Gray, LA 70359 | 2005-06-24 |
| 1750387676 | Donald Severinus Gervais Jr. | Psychiatry & Neurology | 128 Neuroscience Ct, Gray, LA 70359 | 2005-06-24 |
| 1114445194 | Teri Lynn Chatagnier | Counselor | 307 Lola St, Gray, LA 70359-3017 | 2017-08-30 |
| 1275039695 | Lashekia J Toussaint | Nurse Practitioner | 137 Marietta Pl, Gray, LA 70359-3119 | 2018-04-04 |
| 1063629772 | Tri-parish Orthopedic & Neurosurgical Institute,llc | Specialist | 115 Eureka Dr, Gray, LA 70359-3247 | 2007-05-16 |
| 1609125566 | Britany Keyon Jackson | Pharmacist | 309 Linda Ann Ave, Gray, LA 70359-3316 | 2012-09-06 |
| Find all providers in zip 70359 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700877297 | Ultrasound Enterprise LLC | Radiology | 165 Frontage Road, Suite B, Gray, LA 70359 | 2005-11-02 |
| 1750467007 | Wendy Suddeth Gervais | Radiology | 128 Neuroscience Ct, Gray, LA 70359-5209 | 2006-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447726518 | Avail Lc Radiology LLC | Radiology | 3730 Nelson Rd, Lake Charles, LA 70605-2412 | 2018-10-16 |
| 1801383245 | St Marys Imaging Center II | Radiology | 4809 Ambassador Caffery Pkwy Ste 350, Lafayette, LA 70508-8801 | 2018-04-20 |
| 1801393590 | Sterling Spine, LLC | Radiology | 708 N Ashley Ridge Loop Ste 400, Shreveport, LA 71106-7234 | 2018-04-09 |
| 1982116497 | Dm Properties of Rapides, LLC | Radiology | 2705 Highway 28 E Ste B, Pineville, LA 71360 | 2017-10-25 |
| 1366977092 | John-paul Grenier | Radiology | 800 Old Metairie Dr, Metairie, LA 70001-6095 | 2017-05-01 |
| 1588023980 | Louisiana Diagnostic and Imaging | Radiology | 5633 Cormier Rd, Vinton, LA 70668-6316 | 2016-02-15 |
| 1285020800 | Noah Mcgill | Radiology | 15790 Paul Vega Md Drive, Radiology, Hammond, LA 70403-7040 | 2015-04-09 |
| 1457790255 | Sulphur Healthcare Partners | Radiology | 3649 S Beglis Pkwy, Sulphur, LA 70665-8107 | 2013-06-14 |
| 1013250703 | Paul Jude Sibille | Radiology | 1240 Highway 761, Church Point, LA 70525-7527 | 2013-04-01 |
| 1982946562 | Rachael Lane Guillory | Radiology | 1811 Dulles Dr, Lafayette, LA 70506-3724 | 2013-03-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.