LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER (NPI# 1962674713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962674713 |
| Entity Type | Organization |
| Organization Name | LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER |
| Other Organization Name | LSU CLINICS OF MONROE |
| Practice Address |
4864 Jackson St Monroe LA 71202-6400 |
| Mailing Address |
1501 Kings Hwy Shared Billing Services Shreveport LA 71103-4228 |
| Practice Telephone | 3183307000 |
| Practice Fax Number | 3186755666 |
| Mailing Telephone | 3186755000 |
| Mailing Fax Number | 3186755666 |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |
| Authorized Official Name | MRS. MELANIE H SOTAK (DIRECTOR OF MANAGED CARE) |
| Authorized Official Telephone | 3186757737 |
| Authorized Official Credential | MHSA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 142 | LA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 142 | LA | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 142 | LA | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | 142 | LA | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
142 | LA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 142 | LA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 142 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1792896 | 05 |
| Other Name | Type Code |
|---|---|
| LSU Clinics of Monroe | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871765982 | Louisiana State University Health Sciences Center | Family Medicine | 2351 Vandenburg Drive, Alexandria, LA 71311 | 2008-03-28 |
| 1154461937 | Louisiana State University Health Sciences Center | Audiologist | 3735 Blair Dr, Shreveport, LA 71103-4601 | 2007-02-08 |
| 1346609526 | Louisiana State University Health Sciences Center | Durable Medical Equipment & Medical Supplies | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2016-02-17 |
| 1801239926 | Louisiana State University Health Sciences Center | General Acute Care Hospital | 5825 Airline Hwy, Baton Rouge, LA 70805-2408 | 2013-04-08 |
| 1144544529 | Louisiana State University Health Sciences Center | Counselor | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2010-03-15 |
| 1689901316 | Louisiana State University Health Sciences Center | Counselor | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2009-11-18 |
| 1437383106 | Louisiana State University Health Sciences Center | Clinical Medical Laboratory | 1501 Kings Hwy, Dpeartment of Surgery Histocompatibility Laboratory, Shreveport, LA 71103-4228 | 2009-05-11 |
| 1649438532 | Louisiana State University Health Sciences Center | Internal Medicine | 1501 Kings Hwy, Department of Internal Medicine - Section of Nephrology, Shreveport, LA 71103-4228 | 2008-05-28 |
| 1316119167 | Louisiana State University Health Sciences Center | Internal Medicine | 4864 Jackson St, Monroe, LA 71202-6400 | 2008-04-01 |
| 1952573701 | Louisiana State University Health Sciences Center | General Acute Care Hospital | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2008-04-01 |
| Street Address |
4864 JACKSON ST |
| City | MONROE |
| State | LA |
| Zip Code | 71202-6400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215939210 | Brfhh Monroe LLC | General Acute Care Hospital | 4864 Jackson St, Hospital Administration, Monroe, LA 71202-6400 | 2005-08-10 |
| 1952900250 | Modnath Sangroula | Student in an Organized Health Care Education/Training Program | 4864 Jackson St, Monroe, LA 71202-6400 | 2020-10-19 |
| 1265030258 | Aastha Garg | Student in an Organized Health Care Education/Training Program | 4864 Jackson St, Monroe, LA 71202-6400 | 2020-10-13 |
| 1639776917 | Yagyesh Karki | Student in an Organized Health Care Education/Training Program | 4864 Jackson St, Monroe, LA 71202-6400 | 2020-10-08 |
| 1265039366 | Jessica Hagan | Nurse Practitioner | 4864 Jackson St, Monroe, LA 71202-6400 | 2020-10-02 |
| 1295332302 | Takinya Raneese Binion-minor | Nurse Practitioner | 4864 Jackson St, Monroe, LA 71202-6400 | 2020-10-02 |
| 1346857604 | Jamie Lynn Putnam Guillot | Nurse Practitioner | 4864 Jackson St, Monroe, LA 71202-6400 | 2020-09-30 |
| 1275149601 | Hemanth Kilaru | Student in an Organized Health Care Education/Training Program | 4864 Jackson St, Monroe, LA 71202-6400 | 2020-09-21 |
| 1457966525 | Julia Lynn Bell | Nurse Anesthetist, Certified Registered | 4864 Jackson St, Monroe, LA 71202-6400 | 2020-09-15 |
| 1821628165 | Lauren Holston Walker | Nurse Practitioner | 4864 Jackson St, Monroe, LA 71202-6400 | 2020-01-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170726 | Ap&g Transportation LLC | Non-emergency Medical Transport (VAN) | 211 Malvern St., Monroe, LA 71202 | 2020-09-30 |
| 1902419625 | Marilyn F Goldman | Non-emergency Medical Transport (VAN) | 1001 Wilton Dr, Monroe, LA 71202 | 2020-08-24 |
| 1114583069 | Brandon Rashaard Collins | Case Manager/Care Coordinator | 5504 Robinson Drive, Monroe, LA 71202 | 2019-05-16 |
| 1285131326 | Jerrel Stills | Counselor | 296 Forest Oaks Rd, Monroe, LA 71202 | 2018-04-06 |
| 1164930269 | Jakira Gibson | Case Manager/Care Coordinator | 308 Vegas Dr, Monroe, LA 71202 | 2018-01-11 |
| 1457870321 | Whitney Nicole Allen | Counselor | 806 North 31st Street, Monroe, LA 71202 | 2017-09-12 |
| 1821535527 | Collins Wade | Counselor | 808 S. Second St., Monroe, LA 71202 | 2017-01-20 |
| 1821533639 | Geoi Smart | Social Worker | 1602 Oaklawn Dr, Monroe, LA 71202 | 2017-01-03 |
| 1699124214 | Melody Miller | Case Manager/Care Coordinator | 205 Stacy Dr Apt A, Monroe, LA 71202 | 2016-06-04 |
| 1548618192 | Samuel Anjera Spivey Jr. | Case Manager/Care Coordinator | 110 Blackwood Dr, Monroe, LA 71202 | 2016-05-24 |
| Find all providers in zip 71202 | ||||
| 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 |
|---|---|---|---|---|
| 1972124832 | Jessica Womack | Family Medicine | 527 W Hurd Rd, Monroe, MI 48162-9205 | 2020-05-01 |
| 1134781412 | Joshua Dwaine Lentz | Family Medicine | Promedica Monroe Regional Hospital, 650 Stewart Road, Monroe, MI 48162 | 2019-07-08 |
| 1376000620 | Paladina Health, LLC | Family Medicine | Paladina Health Monroe Campus Park, 1640 A Campus Park Drive, Monroe, NC 28112 | 2019-02-22 |
| 1457822991 | Affinity Health Group, LLC | Family Medicine | 920 Oliver Rd Ste A2, Monroe, LA 71201-5702 | 2018-12-10 |
| 1144601121 | Rebecca Redding | Family Medicine | 924 W Spring St Ste A, Monroe, GA 30655-1751 | 2015-06-15 |
| 1285069088 | Geaux Family Health, LLC | Family Medicine | 2408 Duval Dr, Suite 1, Monroe, LA 71201-2986 | 2013-09-11 |
| 1033559844 | Mvhe, Inc | Family Medicine | 20 Overbrook Dr Ste C, Monroe, OH 45050-1147 | 2013-06-26 |
| 1982048237 | Erin Robinson Breard | Family Medicine | 3995 Sterlington Rd, Ste A, Monroe, LA 71203-3723 | 2013-04-17 |
| 1659614022 | Mercy Memorial Hospital Corporation | Family Medicine | 650 Steward Road, Monroe, MI 48162 | 2013-04-03 |
| 1598015968 | Urban Medical Clinic, Inc. | Family Medicine | 1910 Jackson St., Monroe, LA 71202-2532 | 2012-09-13 |
| 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.