ST. JUDE CHILDREN'S RESEARCH HOSPITAL (NPI# 1063428688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063428688 |
| Entity Type | Organization |
| Organization Name | ST. JUDE CHILDREN'S RESEARCH HOSPITAL |
| Other Organization Name | ST. JUDE AFFILIATE/BATON ROUGE |
| Practice Address |
7777 Hennessy Blvd Ste. 312 Baton Rouge LA 70808-4300 |
| Practice Telephone | 2257636337 |
| Practice Fax Number | 2257614072 |
| Mailing Telephone | 2257636337 |
| Mailing Fax Number | 2257614072 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHAEL C CANARIOS (VP/CFO) |
| Authorized Official Telephone | 9014953006 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | AETNA | 2678828 | 01 |
| MS | 01554572 | 05 | |
| LA | 1446131 | 05 |
| Other Name | Type Code |
|---|---|
| St. Jude Affiliate/Baton Rouge | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ST. JUDE CHILDREN'S RESEARCH HOSPITAL | 501 St Jude Place, Memphis, TN 38105 |
| Vermont Business Registrations | ST. JUDE CHILDREN'S RESEARCH HOSPITAL | 501 St. Jude Place, Memphis, TN 38105 |
| System for Award Management (SAM) Entities | ST. JUDE CHILDREN'S RESEARCH HOSPITAL GRADUATE SCHOOL OF BIOMEDICAL SCIENCES, LLC | 262 Danny Thomas Pl, Memphis, TN 38105-3678 |
| System for Award Management (SAM) Entities | ST. JUDE CHILDREN'S RESEARCH HOSPITAL, INC. | 262 Danny Thomas Pl, Memphis, TN 38105-3678 |
| Street Address |
7777 HENNESSY BLVD STE. 312 |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70808-4300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336143841 | Jeffrey Dean Hyde | Internal Medicine | 7777 Hennessy Blvd, Suite 1000, Baton Rouge, LA 70808-4300 | 2005-06-13 |
| 1487211397 | Karrie G Mccoy | Nurse Practitioner | 7777 Hennessy Blvd, Baton Rouge, LA 70808-4300 | 2019-05-27 |
| 1912466160 | Paige Cantrell Guillory | Student in an Organized Health Care Education/Training Program | 7777 Hennessy Blvd, Baton Rouge, LA 70808-4300 | 2019-03-18 |
| 1699267666 | Osaretin Charles Aimuyo | Pediatrics | 7777 Hennessy Blvd, Baton Rouge, LA 70808-4300 | 2018-06-05 |
| 1962992883 | John Ghassan | Student in an Organized Health Care Education/Training Program | 7777 Hennessy Blvd, Baton Rouge, LA 70808-4300 | 2018-05-16 |
| 1003312414 | Jamie Nicole Scharfschwerdt | Student in an Organized Health Care Education/Training Program | 7777 Hennessy Blvd, Baton Rouge, LA 70808-4300 | 2018-04-04 |
| 1356859888 | Kristen Pilcher Boudreaux | Nurse Anesthetist, Certified Registered | 7777 Hennessy Blvd, Ste 301, Baton Rouge, LA 70808 | 2018-01-18 |
| 1548784192 | Erickia Lee Le Meunier | Nurse Practitioner | 7777 Hennessy Blvd, Baton Rouge, LA 70808-4300 | 2017-07-26 |
| 1215457023 | Amy Miller | Nurse Practitioner | 7777 Hennessy Blvd, Baton Rouge, LA 70808-4300 | 2017-06-22 |
| 1053852806 | Kathryn Tetreault | Nurse Anesthetist, Certified Registered | 7777 Hennessy Blvd, Suite 301, Baton Rouge, LA 70808-4300 | 2017-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790313161 | Leah Michelle Dlugolecki | Student in an Organized Health Care Education/Training Program | Lsu Psychiatry Residency Program, 5246 Brittany Drive, Baton Rouge, LA 70808 | 2020-03-31 |
| 1003376302 | Kristina Pham | Student in an Organized Health Care Education/Training Program | 5246 Brittany Drive, 3rd Floor, Baton Rouge, LA 70808 | 2019-03-22 |
| 1083174486 | John Jay Hogan | Student in an Organized Health Care Education/Training Program | Lsu Emergency Medicine Residency Program, 5246 Brittany Drive, Baton Rouge, LA 70808 | 2019-03-21 |
| 1033682075 | Joseph Bertell Davis Jr. | Case Manager/Care Coordinator | 2460 College Drive, Baton Rouge, LA 70808 | 2019-01-02 |
| 1508340886 | Jennifer Miatech | Student in an Organized Health Care Education/Training Program | 8585 Picardy Ave., Medical Tower 2, Baton Rouge, LA 70808 | 2018-09-21 |
| 1700389137 | Jenee Robins | Case Manager/Care Coordinator | 2100 College Dr Apt 159, Baton Rouge, LA 70808 | 2018-03-12 |
| 1952812893 | Da Vonna Dents | Behavioral Analyst | 418 Stoney Creek Ave, Baton Rouge, LA 70808 | 2017-10-18 |
| 1962925669 | Katharine Elizabeth Blum | Counselor | 7936 Wrenwood Blvd. Ste A, Baton Rouge, LA 70808 | 2017-07-25 |
| 1801316120 | Amie Jackson | Social Worker | 5420 Corporate Blvd. Ste 308, Baton Rouge, LA 70808 | 2017-06-27 |
| 1235660713 | Melissa A Eddy-shelby | Student in an Organized Health Care Education/Training Program | 5000 Hennessy Blvs, Suite 6004, Baton Rouge, LA 70808 | 2017-03-25 |
| Find all providers in zip 70808 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619291630 | Kacie Lummen Sims | Pediatrics | 7777 Hennessy Blvd Ste 312, Baton Rouge, LA 70808-4365 | 2010-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548502313 | Justin John Farge | Pediatrics | 131 S Robertson St # 8027, New Orleans, LA 70112-2807 | 2013-03-20 |
| 1164666723 | Dana Marie Leblanc | Pediatrics | 7426 Dominican St, New Orleans, LA 70118-3708 | 2009-04-27 |
| 1295902989 | Corey Paul Falcon | Pediatrics | 4720 S I 10 Service Rd W Ste 401, Metairie, LA 70001-1242 | 2008-05-12 |
| 1770755548 | Matthew B Fletcher | Pediatrics | 1315 Jerfferson Highway, New Orleans, LA 70121 | 2008-04-01 |
| 1023121035 | Raymond G. Watts | Pediatrics | 200 Henry Clay Ave., 1st Fl, New Orleans, LA 70118 | 2006-08-16 |
| 1710900758 | Tammuella Evelyn Chrisentery-singleton | Pediatrics | 2053 Gause Blvd E Ste 200, Slidell, LA 70461-5451 | 2006-07-25 |
| 1184043176 | Andrea Bauchat | Pediatrics | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2014-04-08 |
| 1386888634 | Zachary L Leblanc | Pediatrics | 200 Henry Clay Ave, New Orleans, LA 70118 | 2009-04-29 |
| 1255592374 | Robert James Vasquez Jr. | Pediatrics | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2008-06-20 |
| 1780875658 | Faisal Saeed Razzaqi | Pediatrics | 200 Henry Clay Ave, Suite 4109, New Orleans, LA 70118-5720 | 2007-08-06 |
| Find all providers with the same taxonomy | ||||
| City | BATON ROUGE |
| Zip Code | 70808 |
Please comment or provide details below to improve the information on ST. JUDE CHILDREN'S RESEARCH HOSPITAL.
| 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.