OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER (NPI# 1235263724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235263724 |
| Entity Type | Organization |
| Organization Name | OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER |
| Other Organization Name | OUR LADY OF THE LAKE HOSPITAL INC PEDIATRIC PULMONARY CLINIC SLEEP LAB |
| Practice Address |
8415 Goodwood Blvd Suite 105 Baton Rouge LA 70806-7851 |
| Mailing Address |
7777 Hennessy Blvd Plaze 1 Ste 406 Baton Rouge LA 70808-4300 |
| Practice Telephone | 2257654361 |
| Practice Fax Number | 2257654062 |
| Mailing Telephone | 2257653456 |
| Mailing Fax Number | 2257651899 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DAVID E THOMAS (PHYSICIAN) |
| Authorized Official Telephone | 2257653456 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1445584 | 05 |
| Other Name | Type Code |
|---|---|
| Our Lady of the Lake Hospital Inc Pediatric Pulmonary Clinic Sleep Lab | Doing Business As Name - Organization |
| Street Address |
8415 GOODWOOD BLVD SUITE 105 |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70806-7851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033118443 | Horace Jay Collinsworth | Pediatrics | 8415 Goodwood Blvd, Suite 100, Baton Rouge, LA 70806-7851 | 2005-07-18 |
| 1386053031 | Nicole Dinh | Pediatrics | 8415 Goodwood Blvd, Ste. 202, Baton Rouge, LA 70806-7851 | 2014-08-07 |
| 1740697374 | David Benjamin Holmes | Student in an Organized Health Care Education/Training Program | 8415 Goodwood Blvd, Ste. 202, Baton Rouge, LA 70806-7851 | 2014-07-15 |
| 1699181966 | Alma Rosibel Cruz | Allergy & Immunology | 8415 Goodwood Blvd, Ste 202, Baton Rouge, LA 70806-7851 | 2014-07-08 |
| 1326454521 | Hunter Thomas Hamilton | Pediatrics | 8415 Goodwood Blvd, Ste 202, Baton Rouge, LA 70806-7851 | 2014-07-08 |
| 1447682802 | Mary Beth Mazza-ricketts | Nurse Practitioner | 8415 Goodwood Blvd, Suite 100, Baton Rouge, LA 70806-7851 | 2013-08-07 |
| 1497010532 | Sylvia M Sutton | Pediatrics | 8415 Goodwood Blvd, Baton Rouge, LA 70806-7851 | 2012-07-04 |
| 1891094603 | Meagan Teal Blanchard | Pediatrics | 8415 Goodwood Blvd, Suite 104, Baton Rouge, LA 70806-7851 | 2011-03-18 |
| 1356643399 | Our Lady of The Lake Physician Group LLC | Internal Medicine | 8415 Goodwood Blvd, Ste 105, Baton Rouge, LA 70806-7851 | 2010-11-24 |
| 1417184110 | Roberta Carona Vicari | Pediatrics | 8415 Goodwood Blvd, Suite 202, Baton Rouge, LA 70806-7851 | 2009-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467064790 | Horizon Network LLC | Community/Behavioral Health | 921 Lobdell Blvd Suite D, Baton Rouge, LA 70806 | 2020-08-18 |
| 1093324220 | Raghu Rudraraju | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard Baton Rouge General Mid City Medi, Suite 130, Baton Rouge, LA 70806 | 2020-07-23 |
| 1619595584 | Brown's Pharmacy, LLC | Pharmacy | 1718 North Foster Drive, Suite B, Baton Rouge, LA 70806 | 2020-07-08 |
| 1497374847 | Yara Mouawad | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Suite 130, Baton Rouge, LA 70806 | 2020-04-15 |
| 1396364527 | Sai Samyuktha Bandaru | Student in an Organized Health Care Education/Training Program | Brg Mid City Medicine Clinic, 3401 North Boulevard, Sui, Baton Rouge, LA 70806 | 2020-04-08 |
| 1588299812 | Iraneeka S Gustave | Peer Specialist | Kelwood Ave, 8326 Kelwood Ave, Baton Rouge, LA 70806 | 2020-03-06 |
| 1518522192 | Silpita Katragadda | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Brg Midcity Medicine Clinic, Suite 130, Baton Rouge, LA 70806 | 2019-05-08 |
| 1437713997 | Dental Solutions, LLC | Dentist | 5629 Government St, Baton Rouge, LA 70806 | 2019-04-30 |
| 1699249516 | Shea Lafountain | Counselor | 624 Connell's Park Lane, Baton Rouge, LA 70806 | 2019-01-14 |
| 1033682802 | Genesis Specialty Groups, LLC | Clinic/Center | 778 Chevelle Drive, Baton Rouge, LA 70806 | 2019-01-04 |
| Find all providers in zip 70806 | ||||
| Taxonomy Code | 2080P0214X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Pulmonology |
| A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205836558 | David E Thomas | Pediatrics | 2355 Drusilla Ln, Baton Rouge, LA 70809-1443 | 2005-07-28 |
| 1306164926 | Andres Carrion- Vargas | Pediatrics | 7777 Hennessy Blvd, Suite 406, Baton Rouge, LA 70808-4300 | 2010-05-06 |
| 1972645216 | Our Lady of The Lake Regional Medica | Pediatrics | 7777 Hennessy Blvd, Plaza 1 Suite 406, Baton Rouge, LA 70810 | 2007-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780633248 | Michael Kiernan | Pediatrics | 4720 S. I-10 Service Rd. West, Ste 101, Metairie, LA 70001 | 2006-05-10 |
| 1871561241 | Adrienne Prestirdge Savant | Pediatrics | 1430 Tulane Ave Dept Of, New Orleans, LA 70112-2632 | 2006-03-10 |
| 1477526598 | Stephen D Levine | Pediatrics | 120 Innwood Dr, Covington, LA 70433-9123 | 2006-02-09 |
| 1508863002 | Eduardo J Hernandez | Pediatrics | 1430 Lindberg Dr, Slidell, LA 70458-8056 | 2005-06-30 |
| 1376910240 | Wk Pediatric Pulmonology Specialists | Pediatrics | 2530 Bert Koun Loop, Suite 114, Shreveport, LA 71118-3132 | 2015-08-27 |
| 1518354224 | Sasikumar Kilaikode Cheruveettara | Pediatrics | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2015-04-20 |
| 1972873545 | William W Waring Sr. | Pediatrics | 123 Walnut St, #905, New Orleans, LA 70118-4847 | 2012-01-12 |
| 1922186188 | Kristin N. Van Hook | Pediatrics | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2006-11-02 |
| 1487730156 | Fernando A Urrego | Pediatrics | 1514 Jefferson Hwy, New Orleans, LA 70121 | 2006-10-27 |
| 1902980154 | Giovanni Piedimonte | Pediatrics | 200 Henry Clay Ave, New Orleans, LA 70118-5798 | 2006-10-24 |
| Find all providers with the same taxonomy | ||||
| City | BATON ROUGE |
| Zip Code | 70806 |
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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.