SOUTHEASTERN LOUISIANA UNIVERISITY (NPI# 1780075499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780075499 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN LOUISIANA UNIVERISITY |
| Other Organization Name | SLU SPORTS MEDICINE |
| Practice Address |
800 Galloway Dr Dugas Center Hammond LA 70402-0001 |
| Mailing Address |
Po Box 650850 Dept. 1011 Dallas TX 75265-0850 |
| Practice Telephone | 9855495133 |
| Practice Fax Number | 9723673451 |
| Mailing Telephone | 8005559073 |
| Mailing Fax Number | 9723673452 |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |
| Authorized Official Name | JOHN IRWIN (ASST. DIRECTOR FOR SPORTS MEDICINE) |
| Authorized Official Telephone | 9855495133 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SLU Sports Medicine | Doing Business As Name - Organization |
| Street Address |
800 GALLOWAY DR DUGAS CENTER |
| City | HAMMOND |
| State | LA |
| Zip Code | 70402-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437558178 | Megan Hetrick | Specialist/Technologist | 800 Galloway Dr, Hammond, LA 70402-0001 | 2014-08-19 |
| 1326561218 | Ebony Glascock | Specialist/Technologist | 800 Galloway Dr, Hammond, LA 70402-0001 | 2017-07-23 |
| 1821524950 | Justin Walker | Prevention Professional | 800 Galloway Dr, Hammond, LA 70401 | 2017-05-10 |
| 1932641404 | Max Whitsell | Specialist/Technologist | 800 Galloway Dr, Hammond, LA 70402-0001 | 2016-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164980801 | Jordan Moore | Student in an Organized Health Care Education/Training Program | 800 Galloway Drive, Hammond, LA 70402-0001 | 2019-03-12 |
| 1316404049 | Matthew L Blair | Student in an Organized Health Care Education/Training Program | 400 Mane Street 800 Galloway Drive, Hammond, LA 70402-0001 | 2019-02-28 |
| 1336603638 | L'nya Moore | Student in an Organized Health Care Education/Training Program | 400 Mane Street, Hammond, LA 70402-0001 | 2019-01-31 |
| 1306318738 | Louise D Billingsley | Clinical Nurse Specialist | 200 Tennessee Avenue, Hammond, LA 70402-0001 | 2018-12-25 |
| 1285119487 | Lisa W Magliolo | Registered Nurse | 15270 Paul Vega Drive, Hammond, LA 70402-0001 | 2018-10-03 |
| 1144723685 | Benjamen David Messina | Specialist/Technologist | Southeastern Louisiana University, Hammond, LA 70402-0001 | 2018-03-12 |
| 1699213645 | Erin Kennedy | Specialist/Technologist | 400 Tennessee Ave, Hammond, LA 70402-0001 | 2017-02-09 |
| 1477900298 | Nathan Quebedeaux | Specialist/Technologist | Slu 10309, Hammond, LA 70402-0001 | 2016-05-23 |
| 1578950028 | State of Louisiana | Orthopaedic Surgery | 548 Western Ave, Hammond, LA 70402-0001 | 2015-04-22 |
| 1265844237 | Southeastern Louisiana University | Nurse Practitioner | Slu 10720, Hammond, LA 70402-0001 | 2014-05-27 |
| Find all providers in zip 70402 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184155020 | Jace Varkey | Family Medicine | 5500 Hohman Ave Ste 2a, Hammond, IN 46320-1942 | 2017-03-22 |
| 1831501212 | Community Care Network, Inc | Family Medicine | 3432 169th St, Hammond, IN 46323-2542 | 2014-05-20 |
| 1285078709 | Smita Reshma Prasad | Family Medicine | 11344 Copper Hill Dr., Hammond, LA 70403-2697 | 2013-04-26 |
| 1669638425 | John Phillip Cosgrove | Family Medicine | 5818 Columbia Ave, Hammond, IN 46320-2607 | 2008-07-31 |
| 1194913335 | Juan C Martinez | Family Medicine | 15813 Paul Vega Md Dr Ste 201, Hammond, LA 70403-1431 | 2007-10-12 |
| 1558440149 | St Margaret Mercy Healthcare Centers | Family Medicine | 3831 S Hohman Ave, Hammond, IN 46327-1160 | 2006-11-03 |
| 1649378175 | Shiv Kumar Sharma | Family Medicine | 5815 S Calumet Ave, Hammond, IN 46320-2352 | 2006-09-20 |
| 1477659449 | Evan H. Geissler, D.o., Ltd. | Family Medicine | 7134 Calumet Ave, Hammond, IN 46324-2406 | 2006-09-16 |
| 1962428953 | Family Medicine Physicians, L.L.C. | Family Medicine | 16052 Doctor's Boulevard, Hammond, LA 70403 | 2006-07-14 |
| 1437180346 | Rujuta R Gandhi | Family Medicine | 4022 Hohman Ave, Hammond, IN 46327-1239 | 2006-07-06 |
| Find all providers in HAMMOND | ||||
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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.