ISLAND MEDICAL SP LLC (NPI# 1295080869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295080869 |
| Entity Type | Organization |
| Organization Name | ISLAND MEDICAL SP LLC |
| Other Organization Name | ISLAND MEDICAL SP, LLC-MONROE |
| Practice Address |
309 Jackson St Monroe LA 71201-7407 |
| Mailing Address |
12420 Milestone Center Dr Ste 200 Germantown MD 20876-7111 |
| Practice Telephone | 4068623002 |
| Mailing Telephone | 2406862300 |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2020-06-03 |
| Authorized Official Name | MS. AMY CHARLEY (CHIEF LEGAL OFFICER) |
| Authorized Official Telephone | 2406862300 |
| Authorized Official Credential | ESQ |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Island Medical SP, LLC-Monroe | Other Name - Individual/Organization |
| Street Address |
309 JACKSON ST |
| City | MONROE |
| State | LA |
| Zip Code | 71201-7407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174524367 | Stephen Paul Blanchard Sr. | Pathology | 309 Jackson St, Monroe, LA 71201-7407 | 2005-08-10 |
| 1255949921 | Shannon L Moe | Registered Nurse | 309 Jackson St, Monroe, LA 71201-7407 | 2020-07-20 |
| 1134756539 | Carolinska Health Corporation | Family Medicine | 309 Jackson St, Monroe, LA 71201-7407 | 2020-03-25 |
| 1649833583 | Ken Gremillion | Nurse Practitioner | 309 Jackson St, Monroe, LA 71201-7407 | 2019-04-16 |
| 1891257515 | Ainsley L Manning | Nurse Practitioner | 309 Jackson St, Monroe, LA 71201-7407 | 2019-04-02 |
| 1295216018 | Andrew Michael Fontenot | Pharmacist | 309 Jackson St, Monroe, LA 71201-7407 | 2018-08-29 |
| 1982180337 | Amber Brooke Etheridge | Registered Nurse | 309 Jackson St, Monroe, LA 71201 | 2018-07-18 |
| 1578070363 | Fmol Health Systems | Pharmacy | 309 Jackson St, Floor 1, Monroe, LA 71201-7407 | 2018-01-03 |
| 1104336460 | Harikrishna Bandla | Internal Medicine | 309 Jackson St, Monroe, LA 71201-7407 | 2017-10-01 |
| 1285156760 | Trisandhya Sharma | Hospitalist | 309 Jackson St, Monroe, LA 71201-7407 | 2017-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831035 | Tammy Price | Social Worker | 414 Pine Street, Monroe, LA 71201 | 2020-04-30 |
| 1932749116 | Emmanuel Brown Jr. | Case Manager/Care Coordinator | 2808 Evangeline Street, Monroe, LA 71201 | 2020-01-15 |
| 1063050961 | James J Gregory | Social Worker | 4800 S Grand, Monroe, LA 71201 | 2019-12-11 |
| 1285271221 | William Fairley | Non-emergency Medical Transport (VAN) | 1002 N. 7th St., Apt. 4, Monroe, LA 71201 | 2019-12-10 |
| 1619431715 | Guidance Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 1204 Stubbs Ave. Suite B, Monroe, LA 71201 | 2019-01-23 |
| 1184193286 | Marnesha Davis | Assistant Behavior Analyst | 500 N. 21st Street, Monroe, LA 71201 | 2018-11-19 |
| 1912476482 | Gbc Hope | Residential Treatment Facility, Emotionally Disturbed Children | 311 South 1st Street, Monroe, LA 71201 | 2018-11-14 |
| 1124502505 | Orthopaedic Clinic of Monroe | Non-Pharmacy Dispensing Site | 1501 Louisville Ave., Monroe, LA 71201 | 2018-09-20 |
| 1699266643 | Melissa Anne De La O | Audiologist | 2516 Broadmoor Blvd # 1b, Monroe, LA 71201 | 2018-05-25 |
| 1588153738 | Essential Family Medicine, LLC | Nurse Practitioner | 2014 Tower Dr. Ste A, Monroe, LA 71201 | 2018-05-03 |
| Find all providers in zip 71201 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790161396 | Medexpress Urgent Care, PC - Michigan | Emergency Medicine | 1261 N Telegraph Rd, Monroe, MI 48162-3368 | 2015-08-05 |
| 1497169171 | Leyda Hu | Emergency Medicine | 927 N Macomb St Apt 6c, Monroe, MI 48162-3069 | 2014-06-20 |
| 1215356878 | Sabiha K Barot | Emergency Medicine | Evergreenhealth Monroe, 14701 179th Ave. Se, Monroe, WA 98272 | 2014-04-10 |
| 1083995468 | Five Star Medical Care Pllc | Emergency Medicine | 5 Carter Ln, Unit#111, Monroe, NY 10950-6230 | 2011-08-30 |
| 1134448756 | Carl Christopher Musgrove | Emergency Medicine | 3721 Tilford Cir, Monroe, LA 71201-2067 | 2010-05-21 |
| 1427281013 | James S Chan | Emergency Medicine | 262 N Man St Advantage Care Na LLC Dba Monroe Urgent Ca, Monroe, OH 45050 | 2009-08-28 |
| 1619062163 | Daniel Alec Heinen | Emergency Medicine | 718 N. Macomb Street, Monroe, MI 48162 | 2006-10-03 |
| 1790728228 | Norman Boyd Williams | Emergency Medicine | 2408 Broadmoor Blvd, Suite B, Monroe, LA 71201-2994 | 2006-06-13 |
| 1467491795 | Richard Arriviello Jr. | Emergency Medicine | 3007 Wesley Chapel Stouts Rd Ste B, Monroe, NC 28110-4008 | 2006-06-05 |
| 1700824711 | Lee Feierabend | Emergency Medicine | 1007 Hilton St, Monroe, LA 71201-4317 | 2006-06-02 |
| Find all providers in MONROE | ||||
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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.