SOUTHPARK COMMUNITY HOSPITAL (NPI# 1275513798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275513798 |
| Entity Type | Organization |
| Organization Name | SOUTHPARK COMMUNITY HOSPITAL |
| Practice Address |
314 Youngsville Hwy Lafayette LA 70508-4524 |
| Practice Telephone | 3377694080 |
| Mailing Telephone | 3377694080 |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LINDA DEVILLE (CEO) |
| Authorized Official Telephone | 3377694080 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians | ||
| X | 204F00000X | Transplant Surgery | Allopathic & Osteopathic Physicians | ||
| X | 207KI0005X |
Allergy & Immunology Specialization: Clinical & Laboratory Immunology |
Allopathic & Osteopathic Physicians | ||
| X | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| X | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| X | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| X | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians | ||
| X | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| X | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| X | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| X | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1729388 | 05 | |
| LA | BLUE CROSS | 61343 | 01 |
| Street Address |
314 YOUNGSVILLE HWY |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-4524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013477322 | Minute Med - Omc LLC | Family Medicine | 314 Youngsville Hwy, Lafayette, LA 70508-4524 | 2019-03-22 |
| 1710315478 | Total Renal Care Inc | Clinic/Center | 314 Youngsville Hwy, Suite 125, Lafayette, LA 70508-4524 | 2013-10-16 |
| 1093970915 | Southpark Acquisition Company LLC | Clinic/Center | 314 Youngsville Hwy, Lafayette, LA 70508-4524 | 2008-07-21 |
| 1205015955 | Southpark Acquisition Company LLC | General Acute Care Hospital | 314 Youngsville Hwy, Lafayette, LA 70508-4524 | 2007-10-30 |
| 1013102078 | Stephen Kyle Chauvin | Nurse Anesthetist, Certified Registered | 314 Youngsville Hwy, Lafayette, LA 70508-4524 | 2007-09-12 |
| 1831129592 | Curtis L Sanford II | Nurse Anesthetist, Certified Registered | 314 Youngsville Hwy, Lafayette, LA 70508-4524 | 2006-07-05 |
| 1679518823 | Mark J Landry | Emergency Medicine | 314 Youngsville Hwy, Lafayette, LA 70508-4524 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1184250607 | Learning Grove Therapy LLC | Clinic/Center | 105 Anaheim Lane, Lafayette, LA 70508 | 2020-03-16 |
| 1780218727 | Jennifer Trumps | Case Manager/Care Coordinator | 200 Entergy Parkway, Lafayette, LA 70508 | 2020-02-28 |
| 1740749605 | Hunter Sy Arceneaux | Physical Therapist | 1700 Kaliste Saloom Road, Building 3, Suite 300, Lafayette, LA 70508 | 2019-03-19 |
| 1295292787 | Brad Michael Gros | Counselor | 160 South Beadle Road, Lafayette, LA 70508 | 2019-02-21 |
| 1205337581 | Alternative Perspectives, LLC | Clinic/Center | 2807 Kaliste Saloom Rd Ste B, Lafayette, LA 70508 | 2018-02-22 |
| 1124528807 | Zachariah James Hebert | Counselor | 1602 W Pinhook Rd Suite 100a, The Family Tree, Lafayette, LA 70508 | 2018-02-19 |
| 1164934477 | Ilyas Munshi, Md Apmc | Non-Pharmacy Dispensing Site | 99 W. Martial Ave, Lafayette, LA 70508 | 2017-10-26 |
| 1447761226 | Louisiana Orthopaedic Specialists, LLC | Durable Medical Equipment & Medical Supplies | 4231 Ambassador Caffery Pkwy, Suite 102, Lafayette, LA 70508 | 2017-10-19 |
| 1306365457 | Mk Dixon Counseling and Consulting | Counselor | 105 Industrial Parkway, Lafayette, LA 70508 | 2017-09-10 |
| Find all providers in zip 70508 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629085196 | Glenn Eric Herrmann | Oral & Maxillofacial Surgery | 130 Old Laramie Trl E Bldg 4, Lafayette, CO 80026-7014 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932414851 | Michael D. Daigle Dds Apc | Oral & Maxillofacial Surgery | 100 Melissa Ln, Houma, LA 70360-4058 | 2010-08-16 |
| 1598927196 | Ashraf R Heram | Oral & Maxillofacial Surgery | 1100 Florida Ave # 220, New Orleans, LA 70119-2714 | 2008-06-26 |
| 1194996637 | Richard Tipery Akin | Oral & Maxillofacial Surgery | 614 Connells Park Ln, Baton Rouge, LA 70806-6534 | 2008-03-12 |
| 1114121639 | Hugo St Hilaire | Oral & Maxillofacial Surgery | 2820 Napoleon Ave Ste 810, New Orleans, LA 70115-8235 | 2007-06-11 |
| 1477630515 | Richard Tipery Akin Dds Md Apc | Oral & Maxillofacial Surgery | 614 Connells Park Lane, Baton Rouge, LA 70806 | 2006-11-01 |
| 1033292008 | Michael Delano Daigle | Oral & Maxillofacial Surgery | 100 Melissa Lane, Houma, LA 70360 | 2006-10-23 |
| 1942391362 | Frank W Harmon | Oral & Maxillofacial Surgery | 2120 Bert Kouns, Suite D, Shreveport, LA 71118 | 2006-09-28 |
| 1508877580 | Ronald B Marks | Oral & Maxillofacial Surgery | 1403 Peterman Drive, Alexandria, LA 71301 | 2006-08-11 |
| 1588641096 | Alexandria Oral Surgery Associates LLP | Oral & Maxillofacial Surgery | 1403 Peterman Dr, Alexandria, LA 71301-3433 | 2005-12-27 |
| 1407848443 | Ochsner Clinic LLC | Oral & Maxillofacial Surgery | 10310 The Grove Blvd, Baton Rouge, LA 70836-6455 | 2005-08-16 |
| 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.