SOUTHCARE MEDICAL LLC (NPI# 1215294830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215294830 |
| Entity Type | Organization |
| Organization Name | SOUTHCARE MEDICAL LLC |
| Practice Address |
1305 N State St Abbeville LA 70510-2825 |
| Practice Telephone | 3374226240 |
| Practice Fax Number | 3374226241 |
| Mailing Telephone | 3374226240 |
| Mailing Fax Number | 3374226241 |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2016-05-02 |
| Authorized Official Name | CRISTYANA SUGENG (OFFICE MANAGER) |
| Authorized Official Telephone | 3374226240 |
| Authorized Official Credential | B.A |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 200292 | LA | Other Service Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP07807 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 207R00000X | Internal Medicine | MD204625 | LA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MD200292 | LA | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | MD200292 | LA | Allopathic & Osteopathic Physicians |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
2203782387 | LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2406922 | 05 | |
| LA | DEA | 9627021 | 01 |
| LA | LA BOARD OF PHARMACY | 33165 | 01 |
| LA | DHH RHC | 2203782387 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093170433 | Southcare Medical LLC | Pediatrics | 110 Curran Ln, Lafayette, LA 70506 | 2015-12-30 |
| Street Address |
1305 N STATE ST |
| City | ABBEVILLE |
| State | LA |
| Zip Code | 70510-2825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437160231 | Simone Adel Pitre | Nurse Practitioner | 1305 N State St, Abbeville, LA 70510-2825 | 2006-08-10 |
| 1891153813 | Amanda Duplantis | Nurse Practitioner | 1305 N State St, Abbeville, LA 70510-2825 | 2016-02-04 |
| 1790198208 | Yelena Magay | Nurse Practitioner | 1305 N State St, Abbeville, LA 70510-2825 | 2014-06-03 |
| 1770747834 | Anita Deborah | Internal Medicine | 1305 N State St, Abbeville, LA 70510-2825 | 2008-07-17 |
| 1649303330 | Budi N Sugeng | Pediatrics | 1305 N State St, Abbeville, LA 70510-2825 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922532209 | Desiree Thomas | Case Manager/Care Coordinator | 336 Sucre Cir, Abbeville, LA 70510 | 2017-04-13 |
| 1578821948 | Dyson & Dyson Inc. | Clinic/Center | 322 Messina St., Abbeville, LA 70510 | 2012-04-24 |
| 1154539518 | Claude H Meeks | Family Medicine | 2615 North Drive, Abbeville, LA 70510 | 2007-05-18 |
| 1922141050 | Dr Gerald Baudin Dds A Dental Corporation | Dentist | 2623 South Drive, Abbeville, LA 70510 | 2007-02-15 |
| 1922149434 | Edward R Chauvin Chiropractic, Ltd | Chiropractor | 1000 Wildcat Drive, Abbeville, LA 70510 | 2007-02-08 |
| 1811033558 | David Wayne Craft | Psychiatry & Neurology | 318 North Hospital Drive, Abbeville, LA 70510 | 2007-01-29 |
| 1356490049 | Diversified Healthcare Abbeville, LLC | Skilled Nursing Facility | 4000 Rodeo Rd., Abbeville, LA 70510 | 2007-01-10 |
| 1104902071 | Young Eye Surgery Center | Clinic/Center | 204 W Magdelen Square, Abbeville, LA 70510 | 2006-10-31 |
| 1962582221 | Dr. Robert Jackson Young IIi | Ophthalmology | 204 Magdalen Square, Abbeville, LA 70510 | 2006-10-17 |
| 1164430914 | Nguyen Chiropractic, Inc. | Chiropractor | 1720 Veterans Memorial Dr., Abbeville, LA 70510 | 2006-08-04 |
| Find all providers in zip 70510 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790744506 | Abbeville General Hospital | Clinic/Center | 2419 Alonzo St, Abbeville, LA 70510-4008 | 2006-03-21 |
| 1285618132 | Abbeville County Memorial Hospital | Clinic/Center | 901 W Greenwood St Ste 1, Abbeville, SC 29620-5717 | 2005-12-05 |
| 1629371661 | Abbeville County Memorial Hospital | Clinic/Center | 901 W Greenwood St Ste 1, Abbeville, SC 29620-5717 | 2010-12-14 |
| 1740350966 | Family Medicine Associates of Abbeville, P.a. | Clinic/Center | 901 W Greenwood St, Suite 9, Abbeville, SC 29620-5678 | 2006-11-08 |
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| 1568062446 | Lhcg Clxix, LLC | Clinic/Center | 821 N Union St, Opelousas, LA 70570-6313 | 2020-10-29 |
| 1760089791 | Blanchard Medical | Clinic/Center | 5948 N Market St, Shreveport, LA 71107-2017 | 2020-10-02 |
| 1922619238 | Pediatric Group of Acadiana, LLC | Clinic/Center | 818 W. Veterans Memorial, Kaplan, LA 70548 | 2020-08-11 |
| 1720606478 | Dr Lawanda Lamar Bellamy Md A Professional Medical Corporation | Clinic/Center | 1307 Crowley-rayne Hwy, Suite B, Crowley, LA 70526 | 2020-07-09 |
| 1669002002 | Franklin Parish Hospital Service Dist 1 | Clinic/Center | 7645 Gilbert Street, Gilbert, LA 71336 | 2020-01-24 |
| 1184260937 | Children's International, LLC | Clinic/Center | 5151 Plank Rd Ste 190, Baton Rouge, LA 70805-3501 | 2019-11-26 |
| 1003467440 | Clhg-acadian LLC | Clinic/Center | 151 Hill St Ste 102, Eunice, LA 70535-5845 | 2019-09-26 |
| 1164073524 | Tangi Wellness & Health | Clinic/Center | 906 C M Fagan Dr Ste B3, Hammond, LA 70403-6056 | 2019-09-26 |
| 1679126510 | Pediatric Group of Acadiana, LLC | Clinic/Center | 1307 Crowley Rayne Hwy Ste C, Crowley, LA 70526-8210 | 2019-07-19 |
| 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.