PELICAN PHYSICIAN SERVICES, LLC (NPI# 1851609978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851609978 |
| Entity Type | Organization |
| Organization Name | PELICAN PHYSICIAN SERVICES, LLC |
| Practice Address |
2375 Gause Blvd E Slidell LA 70461-4142 |
| Practice Telephone | 9856459000 |
| Practice Fax Number | 9856450359 |
| Mailing Telephone | 9856459000 |
| Mailing Fax Number | 9856450359 |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2014-07-09 |
| Authorized Official Name | DR. KUMAR KISHORE AMARANENI (OWNER/REGISTERED AGENT) |
| Authorized Official Telephone | 9856459000 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 019740 | LA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 025659 | LA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 025659 | LA | Allopathic & Osteopathic Physicians |
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
06512R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1442119 | 05 |
| Street Address |
2375 GAUSE BLVD E |
| City | SLIDELL |
| State | LA |
| Zip Code | 70461-4142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629057856 | Deepak S. Dixit | Emergency Medicine | 2375 Gause Blvd E, Slidell, LA 70461-4142 | 2006-01-16 |
| 1962013581 | Megan Rebecca Weidemann | Registered Nurse | 2375 Gause Blvd E, Slidell, LA 70461-4142 | 2020-08-17 |
| 1548755770 | Ochsner Clinic LLC | Internal Medicine | 2375 Gause Blvd E, Slidell, LA 70461-4142 | 2018-06-29 |
| 1891047569 | Yvonnie Oakley | Nurse Practitioner | 2375 Gause Blvd E, Slidell, LA 70461-4142 | 2012-10-05 |
| 1437405180 | Shannon Paul Pippin | Registered Nurse | 2375 Gause Blvd E, Slidell, LA 70461-4142 | 2012-07-31 |
| 1518191188 | Laderer Physician Services | Family Medicine | 2375 Gause Blvd E, Slidell, LA 70461-4142 | 2009-05-11 |
| 1144404534 | Natalia B Hannan | Surgery | 2375 Gause Blvd E, Slidell, LA 70461-4142 | 2007-12-21 |
| 1164559845 | Naeem & Kumar LLC | Clinic/Center | 2375 Gause Blvd E, Slidell, LA 70461-4142 | 2007-02-28 |
| 1750497269 | Kumar Kishore Amaraneni | Emergency Medicine | 2375 Gause Blvd E, Slidell, LA 70461-4142 | 2006-08-21 |
| 1497773535 | Gollamudi H Reddy I | Physical Medicine & Rehabilitation | 2375 Gause Blvd E, Slidell, LA 70461-4142 | 2006-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013553577 | Kira Gilmore Smith | Nurse Practitioner | Pelican Urgent Care, 2375 Gause Blvd. East, Slidell, LA 70461 | 2019-11-20 |
| 1104477256 | Peter Khong | Pharmacy | 2915 Us-190, Mandeville, LA 70461 | 2019-09-20 |
| 1457844706 | April Hughes Whitfield | Counselor | 1313 Brownswitch Rd, Ste D, Slidell, LA 70461 | 2018-06-12 |
| 1154824761 | Lisa Michele Mcclinton | Counselor | 1212 Montgomery Blvd, Slidell, LA 70461 | 2018-03-10 |
| 1952816902 | Keiona Monae Thompson | Counselor | 1121 Clairise Ct, Slidell, LA 70461 | 2017-12-12 |
| 1275048688 | Aisha Cade | Counselor | 250 Cross Gates Blvd, Slidell, LA 70461 | 2017-12-07 |
| 1598285405 | Sureway Transits | Non-emergency Medical Transport (VAN) | 135 Rue De La Paix, Slidell, LA 70461 | 2017-06-21 |
| 1043743198 | Natasha Hunter | Counselor | 1650 Barrymore St, Slidell, LA 70461 | 2017-04-05 |
| 1154873891 | Chaise A Bennett | Physical Therapist | 2040 Gause Blvd, Suite 6, Slidell, LA 70461 | 2016-10-28 |
| 1104373539 | Kaonta Simmons | Counselor | 2185 Wellington Ln, Slidell, LA 70461 | 2016-09-01 |
| Find all providers in zip 70461 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013023803 | Archie C Tatford | Emergency Medicine | 1001 Gause Blvd, Slidell, LA 70458-2939 | 2006-08-22 |
| 1609982479 | Angie M Ragas | Emergency Medicine | 1001 Gause Blvd, Emergency Room, Slidell, LA 70458-2939 | 2006-08-22 |
| 1497861827 | Edward Joseph Lirette | Emergency Medicine | 1001 Gause Blvd, Emergency Room, Slidell, LA 70458-2939 | 2006-08-21 |
| 1750497269 | Kumar Kishore Amaraneni | Emergency Medicine | 2375 Gause Blvd E, Slidell, LA 70461-4142 | 2006-08-21 |
| 1861443533 | Cuong Van Le | Emergency Medicine | 501 Robert Blvd, 1st Floor, Slidell, LA 70458-1667 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639662539 | Doctor By Video,llc | Emergency Medicine | 1700 Central Blvd, Harvey, LA 70058-3288 | 2018-06-14 |
| 1780028175 | Wayne Thomas Robichaux | Emergency Medicine | 12 Muirfield Dr, La Place, LA 70068-1632 | 2013-04-29 |
| 1639474257 | C&m Medical Services-st Elizabeth LLC | Emergency Medicine | 1125 West Louisiana Highway 30, Gonzales, LA 70737 | 2011-01-12 |
| 1972705333 | Isaac Freeborn | Emergency Medicine | 1507 E Whatley Rd, Oakdale, LA 71463-2318 | 2007-06-05 |
| 1609097898 | Wesley Blake Vanderlan | Emergency Medicine | 400 S Chenier Dr, Madisonville, LA 70447-9389 | 2007-05-02 |
| 1801945936 | Louis Christopher Benjamin IIi | Emergency Medicine | 18961 Santa Maria Dr, Baton Rouge, LA 70809-6765 | 2007-01-09 |
| 1134235989 | Victor E Tuckler | Emergency Medicine | 639 Gelpi Ave, Jefferson, LA 70121-1527 | 2006-08-22 |
| 1710903059 | C & M Medical Services, Inc. | Emergency Medicine | 2450 Severn Ave Ste 205, Metairie, LA 70001 | 2006-07-13 |
| 1720014392 | Huey August Seyfarth Jr. | Emergency Medicine | 1424 Sherwood Forest Blvd, Baton Rouge, LA 70815-5332 | 2006-06-24 |
| 1073554010 | Gina Luisa Greco-angelopoulos | Emergency Medicine | 2640 Country Club Rd, Suite 400, Lake Charles, LA 70605-5912 | 2006-06-09 |
| Find all providers with the same taxonomy | ||||
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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.