MAGNOLIA MEDICAL, LLC (NPI# 1174094304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174094304 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA MEDICAL, LLC |
| Practice Address |
626 Verot School Rd Ste C Lafayette LA 70508-5094 |
| Mailing Address |
5412 Dijon Dr Baton Rouge LA 70808-4315 |
| Practice Telephone | 3372102060 |
| Practice Fax Number | 8885446008 |
| Mailing Telephone | 2256158693 |
| Mailing Fax Number | 8885446008 |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |
| Authorized Official Name | MARISSA BEESLEY (BILLING MANAGER) |
| Authorized Official Telephone | 6014426493 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476702 | Magnolia Medical, LLC | Prosthetic/Orthotic Supplier | 300 Highland Blvd Ste G, Natchez, MS 39120-4600 | 2020-01-13 |
| 1285060681 | Magnolia Medical, LLC | Prosthetic/Orthotic Supplier | 400 Carter St, Vidalia, LA 71373-3307 | 2013-09-18 |
| 1457786725 | Magnolia Medical, LLC | Prosthetic/Orthotic Supplier | 304 Highland Blvd, Suite B, Natchez, MS 39120-4624 | 2013-09-05 |
| 1689683351 | Magnolia Medical, LLC | Durable Medical Equipment & Medical Supplies | 5412 Dijon Dr, Baton Rouge, LA 70808-4315 | 2006-08-05 |
| Street Address |
626 VEROT SCHOOL RD STE C |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-5094 |
| 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 | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225519242 | Greenwood Shoes | Prosthetic/Orthotic Supplier | 434 Jefferson St, Lafayette, LA 70501-7014 | 2018-08-27 |
| 1881099182 | Colorado Pediatric Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 399 Pika Pt, Lafayette, CO 80026-9072 | 2014-10-29 |
| 1851570964 | Lamberts Limbs & Braces Inc. | Prosthetic/Orthotic Supplier | 107 Energy Pkwy, Lafayette, LA 70508-3817 | 2007-10-25 |
| 1396810990 | Terry's Medical Specialties LLC | Prosthetic/Orthotic Supplier | 119 Leonie St, Lafayette, LA 70506-6227 | 2006-11-21 |
| 1790857803 | Colorado Professional Medical, Inc | Prosthetic/Orthotic Supplier | 1140 W South Boulder Rd Ste 101, Lafayette, CO 80026-8910 | 2006-11-14 |
| 1518070051 | Neurosurgical Applications, LLC | Prosthetic/Orthotic Supplier | 516 Verot School Rd, Lafayette, LA 70508-5026 | 2006-08-17 |
| 1457359408 | American Orthopedic & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 720 Farabee Ct, Lafayette, IN 47905-5917 | 2005-07-13 |
| 1508863689 | Lafayette Orthotics, Inc. | Prosthetic/Orthotic Supplier | 500 Saint Landry St, Lafayette, LA 70506-4626 | 2005-07-05 |
| 1710989066 | Lafayette Health Ventures, Inc. | Prosthetic/Orthotic Supplier | 1438 S College Rd, Lafayette, LA 70503-2912 | 2005-06-01 |
| 1639673965 | Advanced Diagnostic Imaging PC | Prosthetic/Orthotic Supplier | 204 Medical Dr, Lafayette, TN 37083-1719 | 2018-03-21 |
| 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.