MR. RONNIE SELF II (NPI# 1659695674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659695674 |
| Entity Type | Individual |
| Full Name | MR. RONNIE SELF II |
| Practice Address |
1990 Industrial Blvd Houma LA 70363-7055 |
| Practice Telephone | 9858689300 |
| Practice Fax Number | 9858510053 |
| Mailing Telephone | 9858689300 |
| Mailing Fax Number | 9858510053 |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2016-02-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
MD.205335 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2109022 | 05 |
| Street Address |
1990 INDUSTRIAL BLVD |
| City | HOUMA |
| State | LA |
| Zip Code | 70363-7055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730183401 | Shaminder Mohan Gupta | Internal Medicine | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2005-06-09 |
| 1528620564 | Paige M Robichaux | Nurse Practitioner | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2019-06-30 |
| 1871079822 | Amanda Graham Lucas | Nurse Practitioner | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2018-07-12 |
| 1104312560 | Nina Claire Broussard | Nurse Practitioner | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2018-07-09 |
| 1972024099 | Britney Haydel | Physician Assistant | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2017-06-28 |
| 1881145258 | Corey Dupre | Physician Assistant | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2016-10-20 |
| 1609228477 | Matthew Phillip James | Physician Assistant | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2016-07-05 |
| 1801240726 | Stephen Kyle Jones | Anesthesiology | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2016-04-17 |
| 1164889382 | Brandi Lecompte | Nurse Practitioner | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2016-01-19 |
| 1952778623 | Amber Wooldridge Sevin | Nurse Practitioner | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2015-08-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588286991 | Nadish Ravindran | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd Internal Medicine Program, Chabert Medical Center, Houma, LA 70363 | 2020-05-08 |
| 1912527185 | Gurjit Singh Brar | Student in an Organized Health Care Education/Training Program | Chabert Medical Center 1978 Industrial Blvd, Internal Medicine Residency Program, Houma, LA 70363 | 2020-04-17 |
| 1912568718 | Blake P Pitre | Pharmacist | 13087 West Main St, Larose, LA 70363 | 2019-06-24 |
| 1528623212 | Navkiran Singh Jagdev | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd Chabert Medical Center, Internal Medicine Residency Program, Houma, LA 70363 | 2019-05-08 |
| 1376107367 | Sheahahn Vikash Soundranayagam | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program Chabert Medical, Center, 1978 Industrial Blvd, Hourna, LA 70363 | 2019-04-25 |
| 1962991034 | Naveen Silva | Student in an Organized Health Care Education/Training Program | 1976 Industrial Blvd, Internal Medicine Residency Program Chabert Medical Cen, Houma, LA 70363 | 2018-05-04 |
| 1841647526 | Ammad Asad Syed | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd., Internal Medicine Residency Program, Chabert Medical Ce, Houma, LA 70363 | 2016-05-23 |
| 1538514450 | Khizran Rizvi | Internal Medicine | 1978 Industrial Blvd. Chabert Medical Center, Internal Medicine Residency Program, Houma, LA 70363 | 2016-04-28 |
| 1649656836 | David Price | Pharmacist | 9303 East Parke Avenue, Houma, LA 70363 | 2015-08-11 |
| 1346638053 | Donna Marie Neville | Case Manager/Care Coordinator | 137 New Orleans Blvd, Houma, LA 70363 | 2015-01-05 |
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| Taxonomy Code | 207ZP0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. [7/1/2007: definition added, source added, 7/1/2009: defintion reformatted; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology (note: this taxonomy code identifies the "anatomic pathology only" route). To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780766089 | Brigitte H Demoss | Pathology | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-10-19 |
| 1528078144 | Jane Dry | Pathology | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2006-08-08 |
| 1780616953 | Randall Dwight Bass | Pathology | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-07-07 |
| 1720042435 | David R Gyer | Pathology | 8166 Main Street, Houma, LA 70360 | 2006-04-12 |
| 1114990686 | Feaster F Fitzpatrick | Pathology | 8166 Main Street, Houma, LA 70360 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992011209 | David Michael Scollard | Pathology | 1770 Physicians Park Dr, Nhdp, Baton Rouge, LA 70816-3222 | 2010-08-24 |
| 1336378793 | Yukihiro Nakanishi | Pathology | 1430 Tulane Ave Rm 6520, New Orleans, LA 70112-2632 | 2009-07-07 |
| 1033165600 | Patricia Carlin | Pathology | 67241 Industry Ln, Covington, LA 70433-8705 | 2006-05-25 |
| 1114305232 | Xinyu Wu | Pathology | 100 Medical Center Dr, Slidell, LA 70461-5520 | 2015-05-08 |
| 1124448584 | Jehan Abdulsattar | Pathology | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2014-04-23 |
| 1447417159 | Rebecca A F Phillips | Pathology | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2008-05-20 |
| 1588831952 | Courtney Carol Jackson | Pathology | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2008-05-14 |
| 1235329723 | Jeffrey Robert Springer | Pathology | 1901 Perdido St, New Orleans, LA 70112-1393 | 2007-07-31 |
| 1619187945 | Meredith Ashley Lakey | Pathology | 1516 Jefferson Hwy, New Orleans, LA 70121-2429 | 2007-05-23 |
| 1306978432 | Sally Hotard Brewster | Pathology | 5825 Airline Hwy, Baton Rouge, LA 70805-2408 | 2007-03-12 |
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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.