ADVANCED NEURODIAGNOSTIC CENTER, INC (NPI# 1164570883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164570883 |
| Entity Type | Organization |
| Organization Name | ADVANCED NEURODIAGNOSTIC CENTER, INC |
| Practice Address |
2905 Kingman St Metairie LA 70006-6615 |
| Mailing Address |
2905 Kingman St Fl 2 Metairie LA 70006-6615 |
| Practice Telephone | 5048853737 |
| Practice Fax Number | 5048855507 |
| Mailing Telephone | 5048853737 |
| Mailing Fax Number | 5048855507 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2011-10-11 |
| Authorized Official Name | SIMIN MIRTAHERI (PRESIDENT) |
| Authorized Official Telephone | 5048853737 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | AP06242 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 2084P2900X |
Psychiatry & Neurology Specialization: Pain Medicine |
201074 | LA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
LA | Allopathic & Osteopathic Physicians | |
| N | 2084S0012X |
Psychiatry & Neurology Specialization: Sleep Medicine |
LA | Allopathic & Osteopathic Physicians | |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
LA | Allopathic & Osteopathic Physicians | |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | BCBS | 4391937610 | 01 |
| LA | BCBS | 767164775A | 01 |
| LA | BCBS | 435707150C | 01 |
| LA | 1946613 | 05 | |
| LA | BLUE CROSS | 548670743D | 01 |
| Street Address |
2905 KINGMAN ST |
| City | METAIRIE |
| State | LA |
| Zip Code | 70006-6615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750347878 | John Kevin Jackson | Psychiatry & Neurology | 2905 Kingman St, Metairie, LA 70006-6615 | 2006-04-26 |
| 1609313345 | Nelville Reehlmann | Orthopaedic Surgery | 2905 Kingman St, Metairie, LA 70006-6615 | 2017-01-19 |
| 1013218494 | Erika May Broussard | Nurse Practitioner | 2905 Kingman St, Metairie, LA 70006-6615 | 2010-11-16 |
| 1235368937 | Headache Center of New Orleans | Neurological Surgery | 2905 Kingman St, Metairie, LA 70006-6615 | 2009-07-02 |
| 1003088915 | Amy Wilcox Voigt | Psychiatry & Neurology | 2905 Kingman St, Metairie, LA 70006-6615 | 2008-03-31 |
| 1184775074 | Advanced Sleep Center, Inc | Durable Medical Equipment & Medical Supplies | 2905 Kingman St, 3rd Floor, Suite 3, Metairie, LA 70006-6615 | 2007-01-16 |
| 1508811704 | Morteza Shamsnia | Psychiatry & Neurology | 2905 Kingman St, Metairie, LA 70006-6615 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437786365 | Christina Alder Humble | Behavior Technician | 4201 N 1-10 Service Road W., Metairie, LA 70006 | 2020-03-23 |
| 1285270959 | Brittanie Renee Tank | Behavior Technician | 4201 N 1-10 Service Rd, W, Metairie, LA 70006 | 2019-11-18 |
| 1447896105 | Jacob Dent Dds Dentists of Metairie A Professional Corporation | Dentist | 5201 Veterans Memorial Blvd., Suite A, Metairie, LA 70006 | 2019-11-18 |
| 1417504861 | Caryn Tesia Washington | Behavior Technician | 4201 N 1-10 Service Rd W., Metarie, LA 70006 | 2019-08-21 |
| 1568023356 | Brittany Nicole Davis | Behavioral Analyst | 4201 N-i 10 Service Rd, Metairie, LA 70006 | 2019-06-24 |
| 1295393650 | Beth Ann Martin | Behavior Technician | 4201 N. Service Road W, Metairie, LA 70006 | 2019-05-31 |
| 1942866561 | Manunique Johnson | Behavior Technician | 4201 N-1-10 Service Rd W., Metairie, LA 70006 | 2019-05-20 |
| 1972068419 | Stacey R Phipps | Behavior Technician | 4201 N 1-10 Service Rd. W., Metairie, LA 70006 | 2019-02-08 |
| 1740752799 | Na'triana Clark | Behavior Technician | 4210 N I-10 Service Rd, Metairie, LA 70006 | 2018-12-31 |
| 1861969131 | Lauren Hay Hughes | Behavior Technician | 4201 N 1-10 Service Rd. West, Metairie, LA 70006 | 2018-10-25 |
| Find all providers in zip 70006 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316105182 | Troy Allan Beaucoudray | Psychiatry & Neurology | 3409 Division St, Metairie, LA 70002-4611 | 2008-05-29 |
| 1922293372 | East Jefferson Physicians Group LLC | Psychiatry & Neurology | 4300 Houma Blvd., Ste. 202, Metairie, LA 70006-2924 | 2007-09-10 |
| 1417023748 | Specialized Diagnostics LLC | Psychiatry & Neurology | 3349 Ridgelake Dr, Suite 104, Metairie, LA 70002-3851 | 2006-11-28 |
| 1750347878 | John Kevin Jackson | Psychiatry & Neurology | 2905 Kingman St, Metairie, LA 70006-6615 | 2006-04-26 |
| 1902804933 | Debra L Burris | Psychiatry & Neurology | 110 Veterans Memorial Blvd, Suite 105, Metairie, LA 70005-3027 | 2005-07-13 |
| 1215935275 | Michael T Happel | Psychiatry & Neurology | 110 Veterans Memorial Blvd Ste 325, Metairie, LA 70005-4961 | 2005-07-13 |
| 1891069118 | Daniel J Trahant, Md (apmc) | Psychiatry & Neurology | 3901 Houma Blvd, Suite 305, Metairie, LA 70006-2930 | 2012-03-05 |
| 1780974774 | Frank Jefferson Williams Jr. | Psychiatry & Neurology | 3800 Houma Blvd, Ste 205, Metairie, LA 70006-4151 | 2011-04-12 |
| 1639330996 | Brian Wade Peterson | Psychiatry & Neurology | 3800 Houma Blvd, Suite 205, Metairie, LA 70006-4182 | 2008-06-19 |
| 1003088915 | Amy Wilcox Voigt | Psychiatry & Neurology | 2905 Kingman St, Metairie, LA 70006-6615 | 2008-03-31 |
| Find all providers in METAIRIE | ||||
Please comment or provide details below to improve the information on ADVANCED NEURODIAGNOSTIC CENTER, INC.
| 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.