OUR LADY OF THE LAKE ASCENSION, LLC (NPI# 1144468422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144468422 |
| Entity Type | Organization |
| Organization Name | OUR LADY OF THE LAKE ASCENSION, LLC |
| Other Organization Name | ST ELIZABETH PHYSICIANS SPECIALISTS |
| Practice Address |
2647 S Riverview Blvd Gonzales LA 70737-5021 |
| Mailing Address |
2647 S. Riverview Blvd Gonzales LA 70737 |
| Practice Telephone | 2256478511 |
| Practice Fax Number | 2256445213 |
| Mailing Telephone | 2256478511 |
| Mailing Fax Number | 2256445213 |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2009-06-03 |
| Authorized Official Name | DR. JOHN F FRAICHE (PRESIDENT) |
| Authorized Official Telephone | 2257432651 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | OUR LADY OF THE LAKE ASCENSION COMMUNITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
12027R | LA | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
R001375 | LA | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 04796R | LA | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 024919 | LA | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 026022 | LA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St Elizabeth Physicians Specialists | Doing Business As Name - Organization |
| Street Address |
2647 S RIVERVIEW BLVD |
| City | GONZALES |
| State | LA |
| Zip Code | 70737-5021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043218886 | John F. Fraiche | Family Medicine | 2647 S Riverview Blvd, Gonzales, LA 70737-5021 | 2005-07-13 |
| 1124152285 | Comprehensive Pain Management, LLC | Specialist | 2647 S Riverview Blvd, St 225, Gonzales, LA 70737-5021 | 2007-03-14 |
| 1053321711 | Footsteps,llc | Durable Medical Equipment & Medical Supplies | 2647 S Riverview Blvd, Suite 316, Gonzales, LA 70737-5021 | 2006-08-08 |
| 1629003793 | Chris G Haik | Nurse Practitioner | 2647 S Riverview Blvd, Gonzales, LA 70737-5021 | 2006-07-11 |
| 1720078603 | Dawn Zitman | Pediatrics | 2647 S Riverview Blvd, Gonzales, LA 70737-5021 | 2005-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461593 | Scott G Petrie Md Apmc | Non-Pharmacy Dispensing Site | 1014 West St Clare Boulevard, Ste 1020, Gonzales, LA 70737 | 2020-09-15 |
| 1407461981 | Bryant Louis Bourgeois | Dentist | 13317 N Burnside, Gonzales, LA 70737 | 2020-09-11 |
| 1821612631 | Kene Anje Hamilton | Behavioral Analyst | 1028 East Worthy Street, Gonzales, LA 70737 | 2020-06-08 |
| 1801428636 | Mercedes Francis | Behavior Technician | 1023 E W Worthy Rd, Gonzales, LA 70737 | 2020-02-10 |
| 1407347586 | Functional Dme | Prosthetic/Orthotic Supplier | 219 W. Eastbank St., Ste B, Gonzales, LA 70737 | 2018-05-23 |
| 1235631789 | Transporting On Purpose | Non-emergency Medical Transport (VAN) | 42148 Conifer Drive, Gonzales, LA 70737 | 2018-03-01 |
| 1215453121 | Michelle Fuller Harris | Social Worker | 39094 N Angelle Ct, Gonzales, LA 70737 | 2017-08-22 |
| 1215452529 | Lani Litchfield | Specialist/Technologist | 13341 W. Mill Grove Dr, Gonzales, LA 70737 | 2017-08-08 |
| 1326569369 | Tyler Joshua Turner | Counselor | 1923 South Edwards, Gonzales, LA 70737 | 2017-06-29 |
| 1518408046 | Margaret Madere | Social Worker | 2827 S Ruby Street, Gonzales, LA 70737 | 2017-03-16 |
| Find all providers in zip 70737 | ||||
| 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 |
|---|---|---|---|---|
| 1689667198 | Karippelil E. Mathew | Surgery | 721 E Highway 30, Gonzales, LA 70737-4715 | 2005-08-30 |
| 1861497026 | Stephen Bernard Manale | Surgery | 1014 West St. Clare Blvd, Suite 3015, Gonzales, LA 70737-2141 | 2005-06-15 |
| 1871772202 | W B Kimbrough IIi | Surgery | 1014 Saint Clair Blvd, Suite 3015, Gonzales, LA 70737-5023 | 2007-11-01 |
| 1649467580 | James Newman Williams | Surgery | 1014 Saint Clair Blvd, Suite 3015, Gonzales, LA 70737-5023 | 2007-09-25 |
| 1821202557 | Amy E Ocmand | Surgery | 1014 Saint Clair Blvd, Suite 3015, Gonzales, LA 70737-5023 | 2007-05-10 |
| 1093936171 | Kathleen Mary Koerner | Surgery | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2007-05-02 |
| 1629136130 | Felino Canendo Oballo | Surgery | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2006-12-05 |
| 1184693582 | Ascension Surgical Associates, LLC | Surgery | 1212 Riverview Blvd, Suite 3020, Gonzales, LA 70737-5023 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376172767 | Chloe Elizabeth Callier | Surgery | 1514 Jefferson Hwy # At2, New Orleans, LA 70121-2429 | 2020-04-07 |
| 1598234338 | Wk Bossier Surgical Associates | Surgery | 2400 Hospital Dr Ste 250, Bossier City, LA 71111-2390 | 2018-11-23 |
| 1730663907 | Ida Molavi | Surgery | Department of Surgery, 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2018-09-24 |
| 1336622158 | The Surgery Clinic of Northeast Louisiana LLC | Surgery | 1503 N 19th St, Monroe, LA 71201-4941 | 2018-09-07 |
| 1578087516 | Dorothy Lewis Md, LLC | Surgery | 52 Oaklawn Dr, Covington, LA 70433-4518 | 2017-08-01 |
| 1417318304 | Colin Stewart Linke | Surgery | 2020 Gravier St Ste 602, New Orleans, LA 70112-2272 | 2016-03-18 |
| 1477922904 | Lafayette Health Ventures, Inc. | Surgery | 121 Audubon Blvd, Lafayette, LA 70503-2606 | 2015-09-15 |
| 1801263926 | Phillip P Crace Md Facs | Surgery | 10440 Hooper Rd, Baton Rouge, LA 70818-3203 | 2015-08-24 |
| 1164805719 | Lafayette Health Ventures, Inc. | Surgery | 900 E Saint Mary Blvd, Suite 106, Lafayette, LA 70503-2377 | 2015-07-01 |
| 1811319353 | Gary Lafleur Sr. | Surgery | 351 N 6th St, Eunice, LA 70535-4138 | 2014-01-17 |
| Find all providers with the same taxonomy | ||||
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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.