NORTHSHORE PROVIDER GROUP LLC (NPI# 1285180158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285180158 |
| Entity Type | Organization |
| Organization Name | NORTHSHORE PROVIDER GROUP LLC |
| Practice Address |
48529 Red Fox Dr Hammond LA 70401-3715 |
| Mailing Address |
Po Box 1063 Hammond LA 70404-1063 |
| Practice Telephone | 3373159686 |
| Mailing Telephone | 3373159686 |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2016-08-30 |
| Authorized Official Name | MR. JAMES I MATHEWS (OWNER) |
| Authorized Official Telephone | 3373159686 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities | ||
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
48529 RED FOX DR |
| City | HAMMOND |
| State | LA |
| Zip Code | 70401-3715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855659 | Tabita Hooper | Dentist | 2807 W Thomas, Hammond, LA 70401 | 2020-06-11 |
| 1689200826 | Thomas Michael Nedow | Specialist/Technologist | 500 W University Avenue, Hammond, LA 70401 | 2020-03-19 |
| 1861025041 | Jonte Bernard | Specialist/Technologist | 1150 N General Pershing, Hammond, LA 70401 | 2020-02-17 |
| 1275196156 | Monica Rome Thompson | Case Manager/Care Coordinator | 1312 N Morrison Blvd, Hammond, LA 70401 | 2019-04-17 |
| 1740752864 | Katelyn D Ennis | Case Manager/Care Coordinator | 1312 N. Morrison Blvd., Hammond, LA 70401 | 2018-12-31 |
| 1396215257 | Breyanna Johnson | Case Manager/Care Coordinator | 1312 North Morrison Blvd, Hammond, LA 70401 | 2018-12-04 |
| 1134695331 | Shanquel Antonet Mckay | Case Manager/Care Coordinator | 1312 N. Morrison Blvd, Hammond, LA 70401 | 2018-10-16 |
| 1598243412 | Brooke Lynn Boggs | Preventive Medicine | 800 North Hazel St., Hammond, LA 70401 | 2018-08-02 |
| 1811499197 | Ashley Daytora Cohn | Counselor | 15043 Woodstone Dr Apt 226, Hammond, LA 70401 | 2018-03-02 |
| 1790207645 | Angela D Dillon | Counselor | 12261 Patrina Ln, Hammond, LA 70401 | 2017-07-12 |
| Find all providers in zip 70401 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326673575 | Lori Miknaitis | Nurse Practitioner | 19065 Dr John Lambert Dr, Hammond, LA 70403-0996 | 2020-03-09 |
| 1265844237 | Southeastern Louisiana University | Nurse Practitioner | Slu 10720, Hammond, LA 70402-0001 | 2014-05-27 |
| 1891917134 | Checkups - La LLC | Nurse Practitioner | 2799 West Thomas Street, Hammond, LA 70401-2838 | 2007-05-03 |
| 1992327639 | Haley Lauren Pierce | Nurse Practitioner | 16014 Doctors Blvd, Hammond, LA 70403-1478 | 2020-05-16 |
| 1861033060 | Erica Lynn Deenihan | Nurse Practitioner | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2019-09-30 |
| 1184283814 | Rae Pitcher | Nurse Practitioner | 15813 Paul Vega Md Dr Ste 100, Hammond, LA 70403-1431 | 2019-06-06 |
| 1376001420 | Kayla Elizabeth Glover | Nurse Practitioner | 16014 Doctors Blvd, Hammond, LA 70403-1478 | 2019-03-07 |
| 1629533872 | Thomas Blodgett | Nurse Practitioner | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2019-02-01 |
| 1508371931 | Megan Perilloux | Nurse Practitioner | 15790 Paul Vega Md Dr, Hammond, LA 70403-1434 | 2017-12-07 |
| 1770941049 | Jennifer Braggs | Nurse Practitioner | 6750 Calumet Ave, Hammond, IN 46324-1646 | 2016-02-02 |
| Find all providers in HAMMOND | ||||
Please comment or provide details below to improve the information on NORTHSHORE PROVIDER GROUP LLC.
| 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.