SHENANDOAH MEDICAL ASSOCIATES, LLC (NPI# 1114025194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114025194 |
| Entity Type | Organization |
| Organization Name | SHENANDOAH MEDICAL ASSOCIATES, LLC |
| Practice Address |
13828 Coursey Blvd Baton Rouge LA 70817-1307 |
| Practice Telephone | 2257524530 |
| Practice Fax Number | 2257524652 |
| Mailing Telephone | 2257524530 |
| Mailing Fax Number | 2257524652 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2014-02-26 |
| Authorized Official Name | GREGORY FERRARA (LLC MEMBER) |
| Authorized Official Telephone | 2257524530 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 015137 | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER | 1931802 | 01 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1931802 | 01 |
| Street Address |
13828 COURSEY BLVD |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70817-1307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356334866 | Christopher Collins Lee | Family Medicine | 13828 Coursey Blvd, Baton Rouge, LA 70817 | 2005-08-30 |
| 1790768729 | Michael G Day | Family Medicine | 13828 Coursey Blvd, Baton Rouge, LA 70817-1307 | 2005-11-23 |
| 1073596094 | Gregory F Ferrara | Family Medicine | 13828 Coursey Blvd, Baton Rouge, LA 70817-1307 | 2005-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518503754 | Optimus Primary Care, LLC | Clinic/Center | 13828 Coursey Boulevard, Address Line 2, Baton Rouge, LA 70817 | 2019-11-22 |
| 1457821043 | Traci Bellazin | Case Manager/Care Coordinator | 9334 Falling Oak Dr., Baton Rouge, LA 70817 | 2018-11-27 |
| 1124502869 | Jacob Schrieffer | Nurse Practitioner | 15389 Airline Highway, Baton Rouge, LA 70817 | 2018-09-19 |
| 1629564638 | Baton Rouge Dental Associates, LLC | Dentist | 14948 Market St, Baton Rouge, LA 70817 | 2018-07-03 |
| 1740786946 | Charlotte L Watts | Nurse Practitioner | 15389 Airline Hwy, Baton Rouge, LA 70817 | 2018-04-05 |
| 1164957536 | Deranecha Francois | Counselor | 17232 Jefferson Hwy, Apt 121, Baton Rouge, LA 70817 | 2017-04-24 |
| 1992251573 | Jacob Dent, Dds. Baton Rouge Modern Dentistry, A Professional Corp | Dentist | 14640 Village Market St, Suite 103, Baton Rouge, LA 70817 | 2016-09-01 |
| 1235522962 | Cardinal Community Services LLC | Clinic/Center | 13702 Coursey Blvd. Bldg 6 Ste A 2, Baton Rouge, LA 70817 | 2015-03-05 |
| 1962832204 | Bcbr Facility Services, LLC | Clinic/Center | 277 Rue De La Vie, Baton Rouge, LA 70817 | 2013-11-23 |
| 1700225737 | Renee Denise Beyer Boudreaux | Nurse Practitioner | 500 Rue De La Vie, Suite 401, Baton Rouge, LA 70817 | 2013-06-24 |
| Find all providers in zip 70817 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376054726 | M V John M D LLC | Non-Pharmacy Dispensing Site | 4021 W E Heck Ct., Building M-1, Baton Rouge, LA 70816 | 2017-10-12 |
| 1497094593 | Symmetrx Medical LLC | Non-Pharmacy Dispensing Site | 9433 Country Lake Dr, Baton Rouge, LA 70817-7028 | 2013-02-08 |
| 1124202486 | Bryan J Bienvenu Md | Non-Pharmacy Dispensing Site | Louisiana Hematology Oncology Assoc, 4950 Essen Lane, Baton Rouge, LA 70809 | 2007-12-21 |
| 1952475311 | Leo Blaize IIi Md | Non-Pharmacy Dispensing Site | 7777 Hennessy Blvd, Ste 7000, Baton Rouge, LA 70808-4300 | 2006-11-20 |
| 1427145614 | Robyn E Tyler Md | Non-Pharmacy Dispensing Site | 7777 Hennessy Blvd, Ste 102, Baton Rouge, LA 70808-4300 | 2006-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461593 | Scott G Petrie Md Apmc | Non-Pharmacy Dispensing Site | 1014 West St Clare Boulevard, Ste 1020, Gonzales, LA 70737 | 2020-09-15 |
| 1689282576 | Total Access Mobility Services | Non-Pharmacy Dispensing Site | 500 Port of New Orleans Pl, New Orleans, LA 70130-1662 | 2020-07-17 |
| 1023570348 | Patrick A Juneau, IIi, Md, Apmc | Non-Pharmacy Dispensing Site | 1103 Kaliste Saloom Rd Ste 206, Lafayette, LA 70508-5784 | 2019-04-04 |
| 1306304050 | Spinal Regeneration Center of La, LLC | Non-Pharmacy Dispensing Site | 189 Greenbrier Blvd Ste C, Covington, LA 70433-7297 | 2019-03-12 |
| 1700356789 | John R. Macgregor Jr. M.d. (apmc) | Non-Pharmacy Dispensing Site | 1502 West Causeway Approach, Suite D, Mandeville, LA 70471 | 2018-12-03 |
| 1124502505 | Orthopaedic Clinic of Monroe | Non-Pharmacy Dispensing Site | 1501 Louisville Ave., Monroe, LA 71201 | 2018-09-20 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1902385354 | Wm. Andre Cenac, Md Apmc | Non-Pharmacy Dispensing Site | 1307 Old Jeanerette Rd Ste 100, New Iberia, LA 70563-5801 | 2018-08-07 |
| 1801394820 | Acadiana Ambulatory Health Care Services | Non-Pharmacy Dispensing Site | 207 Westmark Blvd., Lafayette, LA 70506 | 2018-01-24 |
| 1144734153 | Northshore Interventional Pain Management | Non-Pharmacy Dispensing Site | 7015 Hwy 190 E Service Rd., Ste 101, Covington, LA 70433 | 2017-11-29 |
| Find all providers with the same taxonomy | ||||
| City | BATON ROUGE |
| Zip Code | 70817 |
Please comment or provide details below to improve the information on SHENANDOAH MEDICAL ASSOCIATES, LLC.
| 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.