MARY BIRD PERKINS CANCER CENTER (NPI# 1225274483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225274483 |
| Entity Type | Organization |
| Organization Name | MARY BIRD PERKINS CANCER CENTER |
| Other Organization Name | MARY BIRD PERKINS CANCER CENTER MEDICAID GROUP |
| Practice Address |
4950 Essen Ln Baton Rouge LA 70809-3738 |
| Practice Telephone | 2257670847 |
| Practice Fax Number | 2257660218 |
| Mailing Telephone | 2257670847 |
| Mailing Fax Number | 2257660218 |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2008-12-18 |
| Authorized Official Name | PAUL R. NOWACKI (CFO) |
| Authorized Official Telephone | 2252151223 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Mary Bird Perkins Cancer Center Medicaid Group | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295833580 | Mary Bird Perkins Cancer Center | Radiology | 4950 Essen Lane, Baton Rouge, LA 70809 | 2006-09-20 |
| Street Address |
4950 ESSEN LN |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70809-3738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578563474 | Michael David Dileo | Otolaryngology | 4950 Essen Ln, 4th Floor, Suite A, Baton Rouge, LA 70809-3738 | 2005-07-21 |
| 1407475031 | Allyson Dupre | Registered Nurse | 4950 Essen Ln, Baton Rouge, LA 70809-3738 | 2020-04-14 |
| 1558848234 | Julie Teresa Gomez | Nurse Practitioner | 4950 Essen Ln, Baton Rouge, LA 70809-3738 | 2018-07-25 |
| 1477925527 | Malorie Irwin | Nurse Practitioner | 4950 Essen Ln, Suite 500, Baton Rouge, LA 70809-3738 | 2015-10-28 |
| 1285051540 | Suchit Patel | Radiology | 4950 Essen Ln, Baton Rouge, LA 70809-3738 | 2014-03-25 |
| 1336561539 | Katherine Osusky Castle | Radiology | 4950 Essen Ln, Baton Rouge, Baton Rouge, LA 70809-3738 | 2014-01-08 |
| 1851727192 | Bridgette Janette Pierre | Nurse Practitioner | 4950 Essen Ln, Suite 300, Baton Rouge, LA 70809-3738 | 2013-09-18 |
| 1528406832 | Konstantin Kovtun | Radiology | 4950 Essen Ln, Baton Rouge, LA 70809 | 2013-06-08 |
| 1043568991 | Daniel Joseph Bourgeois IIi | Radiology | 4950 Essen Ln, Baton Rouge, LA 70809-3738 | 2012-08-27 |
| 1740541440 | Tanisha Burrell Smith | Nurse Practitioner | 4950 Essen Ln, Suite 300, Baton Rouge, LA 70809-3738 | 2012-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619582640 | Lisha Kerr Jacobsen | Counselor | 7936 Wrenwood Drive, Bldg # A, Baton Rouge, LA 70809 | 2020-09-15 |
| 1790301596 | Louisiana Regenerative Medicine Center | Clinic/Center | 9456 Jefferson Hwy St A, Baton Rouge, LA 70809 | 2020-06-18 |
| 1093337305 | Sew Luxe Customs, LLC | Prosthetic/Orthotic Supplier | 8674 Quarters Lake Road, Building 11 Suit 1, Baton Rouge, LA 70809 | 2020-05-08 |
| 1366903908 | Tamika Wyna Piper | Counselor | 11445 Reiger Road, Baton Rouge, LA 70809 | 2019-03-27 |
| 1548734213 | Urg-hab Surgical Specialists | Pain Medicine | 8558 Jefferson Hwy, Baton Rouge, LA 70809 | 2019-01-16 |
| 1205306610 | Monique West | Case Manager/Care Coordinator | 9441 Common Street, Suite B, Baton Rouge, LA 70809 | 2018-11-28 |
| 1679061618 | Sara Elizabeth Nicole Altaean | Massage Therapist | Ability Massage & Day Spa, 7656 Jefferson Hwy Suite 1a, Baton Rouge, LA 70809 | 2018-04-25 |
| 1871098921 | Gary Bernard Jr. | Massage Therapist | 7656 Jefferson Hwy Suite 1a, Baton Rouge, LA 70809 | 2018-03-29 |
| 1619476355 | De'andria Banks | Behavior Technician | 9150 Bareford Drive, Baton Rouge, LA 70809 | 2018-02-08 |
| 1427561679 | Angiogenesis Medical LLC | Durable Medical Equipment & Medical Supplies | 8032 Summa Ave Ste D, Baton Rouge, LA 70809 | 2017-11-09 |
| Find all providers in zip 70809 | ||||
| Taxonomy Code | 2085R0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Therapeutic Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740200922 | Mary Ella Sanders | Radiology | 4950 Essen Lane, Baton Rouge, LA 70809-3482 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649320052 | Glenn Rutledge Stewart | Radiology | 607 W Bayou Pkwy, Lafayette, LA 70503-3605 | 2007-01-11 |
| 1669646782 | James G. Maze, Md, Apmc | Radiology | 1701 Oak Park Blvd, Lake Charles, LA 70601-8911 | 2008-04-18 |
| 1194869206 | Larry A. Hauskins, Md | Radiology | 524 S Ryan St, Lake Charles, LA 70601-5725 | 2007-02-20 |
| City | BATON ROUGE |
| Zip Code | 70809 |
Please comment or provide details below to improve the information on MARY BIRD PERKINS CANCER CENTER.
| 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.