Hollie B Ortis (NPI# 1528224425, PAC ID# 1557593324) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
Nation Provider ID (NPI) | 1528224425 |
PAC ID by PECOS | 1557593324 |
Professional Enrollment ID | I20140409001174 |
Full Name | Hollie B Ortis |
Organization Legal Name | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
Address |
13489 Hwy 431 Suite A Saint Amant LA 70774-3213 |
Phone Number | 2256478511 |
Gender | F |
Graduation Year | 2008 |
Primary Specialty | NURSE PRACTITIONER |
Group Practice PAC ID | 4587849781 |
Number of Group Practice Members | 474 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
190064 | OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
13489 Hwy 431, Suite A, Saint Amant, LA 70774-3213 | 2256478511 | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
Organization Legal Name | OUR LADY OF THE LAKE PHYSICIAN GROUP LLC |
Physicians | 443 |
Name | Specialty | Organization | Address |
---|---|---|---|
James Michael Robinson | Family Medicine | Our Lady of The Lake Physician Group LLC | 12525 Perkins Rd A, Baton Rouge, LA 70810-1907 |
Kori Fogg Juban | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 34870 La Hwy 1019, Denham Springs, LA 70706-0659 |
Michelle Duhe | Family Medicine | Our Lady of The Lake Physician Group LLC | 26739 La Hwy 1032, Denham Springs, LA 70726-4926 |
Swapna G Kallu | Internal Medicine | Our Lady of The Lake Physician Group LLC | 214 Clinic Dr, Donaldsonville, LA 70346-4309 |
Montrell Martin-duhe | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 4463 La Hwy 1 S A, Port Allen, LA 70767-5990 |
Joshua R Clark | Family Medicine | Our Lady of The Lake Physician Group LLC | 59315 River W Dr, Suite C, Plaquemine, LA 70764-6553 |
Shantan Ravula | Family Medicine | Our Lady of The Lake Physician Group LLC | 14225 Hwy 73, Prairieville, LA 70769-3616 |
Daniel Kevin Lavie | Hematology/oncology | Our Lady of The Lake Physician Group LLC | 4950 Essen Ln, Suite 400, Baton Rouge, LA 70809-3738 |
Sheri A Ammons | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 5428 Odonovan Dr B, Baton Rouge, LA 70808-4374 |
Sharon Jackson | Nurse Practitioner | Our Lady of The Lake Physician Group LLC | 5247 Didesse Dr, Baton Rouge, LA 70808-9153 |
Street Address |
13489 HWY 431 SUITE A |
City | SAINT AMANT |
State | LA |
Zip | 70774-3213 |
City | SAINT AMANT |
Zip Code | 70774 |
Specialty | NURSE PRACTITIONER |
City + Specialty | SAINT AMANT + NURSE PRACTITIONER |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.