ROBERT MARRIOTT MEDICAL CORP (NPI# 1093266553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093266553 |
| Entity Type | Organization |
| Organization Name | ROBERT MARRIOTT MEDICAL CORP |
| Practice Address |
103 W Martial Ave Lafayette LA 70508-6719 |
| Mailing Address |
222 N Pacific Coast Hwy Ste 2175 El Segundo CA 90245-5639 |
| Practice Telephone | 8778783289 |
| Practice Fax Number | 8778173227 |
| Mailing Telephone | 8778783289 |
| Mailing Fax Number | 8778173227 |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2018-11-08 |
| Authorized Official Name | ROBERT J MARRIOTT (CEO) |
| Authorized Official Telephone | 8778783289 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | ADVANTAGE WOUND CARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2322770 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003367566 | Robert Marriott Medical Corp | Surgery | 713 Midway Ave, Mount Airy, MD 21771-2833 | 2016-10-19 |
| 1467903914 | Robert Marriott Medical Corp | Surgery | 2644 Bristol Rd, Warrington, PA 18976-1404 | 2016-10-19 |
| 1568913010 | Robert Marriott Medical Corp | Surgery | 330 W Ben White Blvd, Austin, TX 78704-8095 | 2016-10-19 |
| 1003367558 | Robert Marriott Medical Corp | Surgery | 113 W Essex St, Maywood, NJ 07607-1023 | 2016-10-19 |
| 1518418128 | Robert Marriott Medical Corp | Surgery | 4900 E Berry St, Fort Worth, TX 76105-4314 | 2016-10-18 |
| 1356892962 | Robert Marriott Medical Corp | Surgery | 130 Spencer Ln, San Antonio, TX 78201-2109 | 2016-10-18 |
| 1073064689 | Robert Marriott Medical Corp | Surgery | 1175 Denton St, Beaumont, TX 77707-3913 | 2016-10-18 |
| 1619428562 | Robert Marriott Medical Corp | Surgery | 603 E Plantation Dr, Clute, TX 77531-5719 | 2016-10-16 |
| 1164973012 | Robert Marriott Medical Corp | Surgery | 711 Matador Ln, Mesquite, TX 75149-8830 | 2016-10-16 |
| 1083883938 | Robert Marriott Medical Corp | Surgery | 222 N Pacific Coast Hwy Ste 2175, El Segundo, CA 90245-5639 | 2008-02-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | ROBERT MARRIOTT MEDICAL CORP. | 28 Liberty Street, New York, New York 10005 |
| Virginia Business Entities | Robert Marriott Medical Corp. | 222 N Pacific Coast Hwy Ste 2175, El Segundo, California 90245-5639 |
| Oregon Corporations, Companies and Business Names | ROBERT MARRIOTT MEDICAL CORP. | 222 North Pacific Coast Hwy, Ste 2175, El Segundo, CA 90245 |
| Oklahoma Business Registrations | ROBERT MARRIOTT MEDICAL CORP. | 863 N Douglas Street, Suite 100, El Segundo, CA 90245 |
| Colorado Business Entities | ROBERT MARRIOTT MEDICAL CORP. | 222 North Pacific Coast Hwy., Ste 1420, El Segundo, CA 90245-5639 |
| Connecticut Business Registrations | ROBERT MARRIOTT MEDICAL CORP. | 222 N Sepulveda Blvd, Suite 2175, El Segundo, CA 90245 |
| Street Address |
103 W MARTIAL AVE |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-6719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538356936 | Cornerstone Village South, Inc | Skilled Nursing Facility | 103 W Martial Ave, Lafayette, LA 70508-6719 | 2007-09-28 |
| 1538789540 | Louisiana Care Services, LLC | Physician Assistant | 103 W Martial Ave, Lafayette, LA 70508-6719 | 2020-04-20 |
| 1184275695 | Dsrm Opco Lafayette LLC | Skilled Nursing Facility | 103 W Martial Ave, Lafayette, LA 70508-6719 | 2019-09-25 |
| 1396395018 | Dsrm Lafayette Opco LLC | Skilled Nursing Facility | 103 W Martial Ave, Lafayette, LA 70508-6719 | 2019-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1184250607 | Learning Grove Therapy LLC | Clinic/Center | 105 Anaheim Lane, Lafayette, LA 70508 | 2020-03-16 |
| 1780218727 | Jennifer Trumps | Case Manager/Care Coordinator | 200 Entergy Parkway, Lafayette, LA 70508 | 2020-02-28 |
| 1740749605 | Hunter Sy Arceneaux | Physical Therapist | 1700 Kaliste Saloom Road, Building 3, Suite 300, Lafayette, LA 70508 | 2019-03-19 |
| 1295292787 | Brad Michael Gros | Counselor | 160 South Beadle Road, Lafayette, LA 70508 | 2019-02-21 |
| 1205337581 | Alternative Perspectives, LLC | Clinic/Center | 2807 Kaliste Saloom Rd Ste B, Lafayette, LA 70508 | 2018-02-22 |
| 1124528807 | Zachariah James Hebert | Counselor | 1602 W Pinhook Rd Suite 100a, The Family Tree, Lafayette, LA 70508 | 2018-02-19 |
| 1164934477 | Ilyas Munshi, Md Apmc | Non-Pharmacy Dispensing Site | 99 W. Martial Ave, Lafayette, LA 70508 | 2017-10-26 |
| 1447761226 | Louisiana Orthopaedic Specialists, LLC | Durable Medical Equipment & Medical Supplies | 4231 Ambassador Caffery Pkwy, Suite 102, Lafayette, LA 70508 | 2017-10-19 |
| 1306365457 | Mk Dixon Counseling and Consulting | Counselor | 105 Industrial Parkway, Lafayette, LA 70508 | 2017-09-10 |
| Find all providers in zip 70508 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477922904 | Lafayette Health Ventures, Inc. | Surgery | 121 Audubon Blvd, Lafayette, LA 70503-2606 | 2015-09-15 |
| 1164805719 | Lafayette Health Ventures, Inc. | Surgery | 900 E Saint Mary Blvd, Suite 106, Lafayette, LA 70503-2377 | 2015-07-01 |
| 1043595804 | Surgical Hospital Management System LLC | Surgery | 1000 Pinhook Road, Suite 310, Lafayette, LA 70503-2460 | 2011-10-12 |
| 1275812976 | Flatirons Surgical Specialists, Pllc | Surgery | 2668 N Park Dr, Ste 110, Lafayette, CO 80026-3199 | 2011-08-11 |
| 1194017889 | Ethel Stackhouse Smith | Surgery | 125 Karolwood Dr, Lafayette, LA 70503 | 2011-05-12 |
| 1306137666 | Imtiaz R Khan | Surgery | 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA 70508-6984 | 2011-04-21 |
| 1386963148 | Leopold Richard, Jr. | Surgery | 406 Oakleaf Dr, Lafayette, LA 70503-3491 | 2010-05-19 |
| 1275760019 | Gary Joseph Arnold | Surgery | 302 Mill Valley Run, Lafayette, LA 70508 | 2009-06-19 |
| 1962681551 | Dennis Joseph Eschete Jr. | Surgery | 1000 W Pinhook Road, Ste 204, Lafayette, LA 70503-2460 | 2007-10-31 |
| 1902999485 | Joseph Peter Lupo | Surgery | 900 E Saint Mary Blvd Ste 104, Lafayette, LA 70503-2378 | 2006-10-02 |
| Find all providers in LAFAYETTE | ||||
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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.