SOUTHERN FERTILITY CENTER (NPI# 1962678144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962678144 |
| Entity Type | Organization |
| Organization Name | SOUTHERN FERTILITY CENTER |
| Practice Address |
1057 Paul Maillard Rd Luling LA 70070-4349 |
| Mailing Address |
3121 Tolmas Dr Metairie LA 70002-5031 |
| Practice Telephone | 9857854211 |
| Mailing Telephone | 9857855610 |
| Mailing Fax Number | 9857853779 |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2008-05-07 |
| Authorized Official Name | DR. SHAILAJA RAJ (PRESIDENT) |
| Authorized Official Telephone | 9857855610 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
MD06325R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1338362 | 05 |
| Street Address |
1057 PAUL MAILLARD RD |
| City | LULING |
| State | LA |
| Zip Code | 70070-4349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295716637 | Hospital Service Dist. No. 1 of The Parish of St. Charles, State of La | Psychiatric Unit | 1057 Paul Maillard Rd, Luling, LA 70070 | 2005-11-11 |
| 1447728019 | Casey A Rahaley | Nurse Practitioner | 1057 Paul Maillard Rd, Luling, LA 70070-4349 | 2018-11-13 |
| 1316481021 | Southern Kidney Specialists, LLC | Internal Medicine | 1057 Paul Maillard Rd, Suite 210, Luling, LA 70070-4349 | 2016-12-14 |
| 1942657192 | Jessica L Adams | Registered Nurse | 1057 Paul Maillard Rd, Luling, LA 70070-4349 | 2016-05-18 |
| 1972957116 | Y'annika Anjane' Edwards | Nurse Practitioner | 1057 Paul Maillard Rd, Luling, LA 70070-4349 | 2016-04-13 |
| 1619331089 | Asfiya Yunus | Family Medicine | 1057 Paul Maillard Rd, Luling, LA 70070-4349 | 2016-04-11 |
| 1750767927 | Mindy Gaubert Hymel | Physician Assistant | 1057 Paul Maillard Rd, Luling, LA 70070-4349 | 2015-08-10 |
| 1447636626 | Nathaly Carrion | Nurse Practitioner | 1057 Paul Maillard Rd, Luling, LA 70070-4349 | 2015-08-10 |
| 1528446101 | Luling Emergency Group LLC | Physician Assistant | 1057 Paul Maillard Rd, Luling, LA 70070-4349 | 2015-05-14 |
| 1033506027 | Amber Lewis | Nurse Practitioner | 1057 Paul Maillard Rd, Ste. D-1900, Luling, LA 70070-4349 | 2015-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447759337 | Kimberly Brown | Specialist/Technologist, Other | 13755 River Road, Luling, LA 70070 | 2018-02-06 |
| 1093213274 | Cherrelle Monique Williams | Counselor | 999 Paul Fredrick Street, Luling, LA 70070 | 2018-01-23 |
| 1699222174 | Latrenda Williams | Counselor | 203 Paul Maillard Road, Luling, LA 70070 | 2016-09-01 |
| 1184028052 | Matthew M Powers | Physical Therapist | 12371 Hwy 90, Ste D, Luling, LA 70070 | 2014-10-21 |
| 1215343959 | Regional Home Care South,llc | Home Health | 50 Wade Street, Ste 3, Luling, LA 70070 | 2014-07-02 |
| 1902143936 | E. Millman Inc | Social Worker | 13201 River Rd, Lvling, LA 70070 | 2013-01-10 |
| 1225369994 | Slm Nonemergency Medical Transportation | Non-emergency Medical Transport (VAN) | 737 Paul Maillard Road, Luling, LA 70070 | 2010-01-20 |
| 1972753192 | Grace Healthcare Management, LLC | Rehabilitation Hospital | 1125 Paul Maillard Road, Luling, LA 70070 | 2008-09-24 |
| 1528214871 | Monica Vial Benson, M.d., Apmc | Physical Medicine & Rehabilitation | 126 Post Drive, Luling, LA 70070 | 2008-08-18 |
| 1609089002 | Damaris D. Bastian, Dds General Dentistry, LLC | Dentist | 1518 Paul Mallard Rd, Luling, LA 70070 | 2007-05-08 |
| Find all providers in zip 70070 | ||||
| Taxonomy Code | 207VE0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Reproductive Endocrinology |
| An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053630962 | Caroline Ragheb Juneau | Obstetrics & Gynecology | 4321 Magnolia St, New Orleans, LA 70115-6227 | 2010-05-18 |
| 1972770410 | Shailaja Raj Apmc | Obstetrics & Gynecology | 3121 Tolmas Dr, Metairie, LA 70002-5031 | 2008-05-14 |
| 1366462368 | David Theodore Vandermolen | Obstetrics & Gynecology | 2401 Greenwood Rd, Suite A, Shreveport, LA 71103-4010 | 2006-07-20 |
| 1184686776 | John Michael Storment | Obstetrics & Gynecology | 206 E Farrel Road, Lafayette, LA 70508-6949 | 2006-04-06 |
| 1821098393 | Robert William Kelly | Obstetrics & Gynecology | 671 Rosa Ave, Ste.101, Metairie, LA 70005-2843 | 2005-07-27 |
| 1740286343 | William Edwin Roniger | Obstetrics & Gynecology | 412 Aurora Ave, Metairie, LA 70005-3212 | 2005-06-28 |
| 1710246210 | Ark-la-tex Fertility & Reproductive Medicine | Obstetrics & Gynecology | 2401 Greenwood Rd, Shreveport, LA 71103-4010 | 2012-05-03 |
| 1265644421 | The Fertility Institute of New Orleans | Obstetrics & Gynecology | 800 N Causeway Blvd, Suite 2c, Mandeville, LA 70448-4664 | 2007-05-03 |
| 1477681385 | Center for Fertility | Obstetrics & Gynecology | 2401 Greenwood Rd, Shreveport, LA 71103-4010 | 2007-03-01 |
| 1053492322 | A Woman's Center for Reproductive Medicine, L.L.C. | Obstetrics & Gynecology | 9000 Airline Hwy, Suite 670, Baton Rouge, LA 70815-4114 | 2006-10-17 |
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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.