SOUTHEAST NEUROSCIENCE CENTER, LLC (NPI# 1285630129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285630129 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST NEUROSCIENCE CENTER, LLC |
| Other Organization Name | IMAGING CENTER OF SOUTH LOUISIANA |
| Practice Address |
128 Neuroscience Ct Gray LA 70359 |
| Mailing Address |
Po Box 4051 Houma LA 70361-4051 |
| Practice Telephone | 9859173007 |
| Practice Fax Number | 9859173010 |
| Mailing Telephone | 9859173007 |
| Mailing Fax Number | 9859173010 |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2016-08-20 |
| Authorized Official Name | MR. GABRIEL LEE NUGENT (DIRECTOR) |
| Authorized Official Telephone | 9858506805 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | LA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1947482 | 05 |
| Other Name | Type Code |
|---|---|
| Imaging Center of South Louisiana | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962881573 | Southeast Neuroscience Center, LLC | Radiology | 970 S Acadia Rd, Thibodaux, LA 70301-4978 | 2015-05-28 |
| 1992184501 | Southeast Neuroscience Center, LLC | Radiology | 1126 Marguerite St, Suite A, Morgan City, LA 70380-1891 | 2015-05-28 |
| 1366820367 | Southeast Neuroscience Center, LLC | Clinic/Center | 8120 Main St, Suite 400, Houma, LA 70360-3403 | 2015-05-11 |
| Street Address |
128 NEUROSCIENCE CT |
| City | GRAY |
| State | LA |
| Zip Code | 70359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972509818 | Edward Stewart Haight | Psychiatry & Neurology | 128 Neuroscience Ct, Gray, LA 70359-5209 | 2005-06-24 |
| 1518566025 | Taylor Michelle Tanner | Physician Assistant | 128 Neuroscience Ct, Gray, LA 70359-5209 | 2020-10-26 |
| 1114530722 | Kallie E Landry | Physician Assistant | 128 Neuroscience Ct, Gray, LA 70359-5209 | 2020-08-25 |
| 1215284963 | Jeanette L Naquin | Nurse Practitioner | 128 Neuroscience Ct, Gray, LA 70359-5209 | 2012-08-13 |
| 1750467007 | Wendy Suddeth Gervais | Radiology | 128 Neuroscience Ct, Gray, LA 70359-5209 | 2006-10-30 |
| 1750387676 | Donald Severinus Gervais Jr. | Psychiatry & Neurology | 128 Neuroscience Ct, Gray, LA 70359 | 2005-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734785 | Cardiovascular Institute of The South Asc, LLC | Clinic/Center | 191 Innovation Court, Gray, LA 70359 | 2020-06-09 |
| 1265985915 | Gavin Triche | Physician Assistant | 128 Neuroscience Court, Gray, LA 70359 | 2016-07-29 |
| 1992939367 | Donna Marie Pugh | Health Maintenance Organization | 216 Champion St, Gray, LA 70359 | 2009-05-13 |
| 1700877297 | Ultrasound Enterprise LLC | Radiology | 165 Frontage Road, Suite B, Gray, LA 70359 | 2005-11-02 |
| 1083610364 | Imaging Center of South Louisiana, LLC | Radiology | 114 Neuroscience Court, Gray, LA 70359 | 2005-06-22 |
| 1114445194 | Teri Lynn Chatagnier | Counselor | 307 Lola St, Gray, LA 70359-3017 | 2017-08-30 |
| 1275039695 | Lashekia J Toussaint | Nurse Practitioner | 137 Marietta Pl, Gray, LA 70359-3119 | 2018-04-04 |
| 1063629772 | Tri-parish Orthopedic & Neurosurgical Institute,llc | Specialist | 115 Eureka Dr, Gray, LA 70359-3247 | 2007-05-16 |
| 1609125566 | Britany Keyon Jackson | Pharmacist | 309 Linda Ann Ave, Gray, LA 70359-3316 | 2012-09-06 |
| 1144612995 | Sade Verdin | Community/Behavioral Health | 3253 W Park Ave, Gray, LA 70359-3512 | 2015-03-02 |
| Find all providers in zip 70359 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932622636 | Jessica Ashley Scearse | Specialist | 1892 Sam Parker Rd, Gray, KY 40734 | 2017-07-25 |
| 1417242710 | Kathy Beard | Specialist | 405 Roy Martin Rd, Ste 104, Gray, TN 37615-2551 | 2011-06-14 |
| 1063629772 | Tri-parish Orthopedic & Neurosurgical Institute,llc | Specialist | 115 Eureka Dr, Gray, LA 70359-3247 | 2007-05-16 |
| 1487799003 | Susan A Curran | Specialist | 2 Mcconkey Rd Ste 3, Gray, ME 04039-9773 | 2007-02-21 |
| 1114912904 | Craig Paul Moorhouse | Specialist | 1440 Suncrest Dr, Gray, TN 37615-4118 | 2005-09-16 |
| 1538304001 | Mary Frances Filonuk | Specialist | 1167 Spratlin Park Dr, Gray, TN 37615-6205 | 2008-12-11 |
| 1952562191 | Ga Pain and Behavioral Medicine Inc. | Specialist | 247 Lana Dr, Gray, GA 31032-5883 | 2008-06-20 |
| 1992911473 | Barbara Elizabeth Chadwick | Specialist | 14 Shaker Rd, Gray, ME 04039-9701 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088417 | Shanteau Sylvester | Specialist | 100 Handy Hill Rd, Mer Rouge, LA 71261-6900 | 2020-06-16 |
| 1346879335 | Donesa Walker | Specialist | 8856 Youree Dr Ste D, Shreveport, LA 71115-2514 | 2020-04-02 |
| 1194363317 | Dorothy Morton | Specialist | 2720 Cedarlawn Dr, Marrero, LA 70072-5414 | 2019-12-18 |
| 1083251086 | Total Medical Billing and Healthcare Services LLC | Specialist | 5836 S Oak Dr, Marrero, LA 70072-5257 | 2019-12-09 |
| 1942863337 | Big Easy Podiatry LLC | Specialist | 3600 Prytania St Ste 75, New Orleans, LA 70115-3674 | 2019-04-21 |
| 1801369855 | Juequita Lashawn Wicker | Specialist | 3180 Convention St Ste B, Baton Rouge, LA 70806-3711 | 2019-01-02 |
| 1164991899 | Hip Hop Barbers, LLC | Specialist | 5709 Hollywood Crossover St, Baton Rouge, LA 70805 | 2018-11-26 |
| 1447749304 | Kelly E Rachal, Dvm | Specialist | 4445 Youree Dr, Shreveport, LA 71105-3618 | 2018-05-07 |
| 1710480736 | Schnell Surgical Services LLC. | Specialist | 3117 Saint Rene St, Metairie, LA 70001-4137 | 2018-03-15 |
| 1841707031 | Jonnika D Allen | Specialist | 3868 Irwin Kuntz Dr, Harvey, LA 70058-2129 | 2018-01-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTHEAST NEUROSCIENCE CENTER, 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.