BRENTON WAYNE MCDONALD (NPI# 1528094455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1528094455 |
Entity Type | Individual |
Full Name | BRENTON WAYNE MCDONALD |
Credential | M.D. |
Practice Address |
2807 Evangeline St Monroe LA 71201-3749 |
Practice Telephone | 3187372269 |
Practice Fax Number | 3183241719 |
Mailing Telephone | 3187372269 |
Mailing Fax Number | 3183241719 |
Enumeration Date | 2006-06-23 |
Last Update Date | 2014-12-11 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
12051R | LA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | MEDICAID | 134436001 | 01 |
LA | 1542288 | 05 | |
LA | RAILROAD MEDICARE | 300101532 | 01 |
Street Address |
2807 EVANGELINE ST |
City | MONROE |
State | LA |
Zip Code | 71201-3749 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841839768 | Jamica Taylor | Case Manager/Care Coordinator | 2807 Evangeline St, Monroe, LA 71201-3749 | 2019-12-23 |
1730728650 | Rynika Polk | Case Manager/Care Coordinator | 2807 Evangeline St, Monroe, LA 71201-3749 | 2019-12-23 |
1548808611 | Bianca M Flucas | Case Manager/Care Coordinator | 2807 Evangeline St, Monroe, LA 71201-3749 | 2019-12-19 |
1144868878 | Erakevia S Edwards | Case Manager/Care Coordinator | 2807 Evangeline St, Monroe, LA 71201-3749 | 2019-12-12 |
1740834167 | Angelica R Mitchell | Counselor | 2807 Evangeline St, Monroe, LA 71201-3749 | 2019-07-25 |
1073165445 | Victoria A. George | Case Manager/Care Coordinator | 2807 Evangeline St, Monroe, LA 71201-3749 | 2019-07-15 |
1851953004 | Tamercy Tellis | Case Manager/Care Coordinator | 2807 Evangeline St, Monroe, LA 71201-3749 | 2019-07-08 |
1417519653 | Macie S. Andrews | Case Manager/Care Coordinator | 2807 Evangeline St, Monroe, LA 71201-3749 | 2019-07-08 |
1437610151 | Melinda Clark | Counselor | 2807 Evangeline St, Monroe, LA 71201-3749 | 2019-03-26 |
1538627955 | Tonesha Hunter | Case Manager/Care Coordinator | 2807 Evangeline St, Monroe, LA 71201-3749 | 2019-03-05 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043831035 | Tammy Price | Social Worker | 414 Pine Street, Monroe, LA 71201 | 2020-04-30 |
1932749116 | Emmanuel Brown Jr. | Case Manager/Care Coordinator | 2808 Evangeline Street, Monroe, LA 71201 | 2020-01-15 |
1063050961 | James J Gregory | Social Worker | 4800 S Grand, Monroe, LA 71201 | 2019-12-11 |
1285271221 | William Fairley | Non-emergency Medical Transport (VAN) | 1002 N. 7th St., Apt. 4, Monroe, LA 71201 | 2019-12-10 |
1619431715 | Guidance Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 1204 Stubbs Ave. Suite B, Monroe, LA 71201 | 2019-01-23 |
1184193286 | Marnesha Davis | Assistant Behavior Analyst | 500 N. 21st Street, Monroe, LA 71201 | 2018-11-19 |
1912476482 | Gbc Hope | Residential Treatment Facility, Emotionally Disturbed Children | 311 South 1st Street, Monroe, LA 71201 | 2018-11-14 |
1124502505 | Orthopaedic Clinic of Monroe | Non-Pharmacy Dispensing Site | 1501 Louisville Ave., Monroe, LA 71201 | 2018-09-20 |
1699266643 | Melissa Anne De La O | Audiologist | 2516 Broadmoor Blvd # 1b, Monroe, LA 71201 | 2018-05-25 |
1588153738 | Essential Family Medicine, LLC | Nurse Practitioner | 2014 Tower Dr. Ste A, Monroe, LA 71201 | 2018-05-03 |
Find all providers in zip 71201 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194068460 | David Soroush Gorovoy | Radiology | 178 Pine Tree Rd, Monroe, NY 10950-3964 | 2013-04-04 |
1659529469 | Michael Barnidge Jr. | Radiology | 1888 Hudson Cir Ste 2, Monroe, LA 71201 | 2008-09-04 |
1407003510 | Presbyterian Imaging Centers LLC | Radiology | 2000 Wellness Boulevard, Ste 110, Monroe, NC 28110-7764 | 2008-08-20 |
1538376116 | Alan Herschman | Radiology | 4 Winnie Palmer Ct, Monroe, NJ 08831-8833 | 2007-05-16 |
1437242070 | Craig Shepherd Smith | Radiology | 718 N. Macomb, Monroe, MI 48161 | 2006-10-02 |
1043227887 | Lovick Pierce Thomas Vi | Radiology | 1601 Lamy Lane, Monroe, LA 71201 | 2006-08-02 |
1891721429 | Anne Dopson Halsell | Radiology | 1888 Hudson Cir, Ste 2, Monroe, LA 71201-3546 | 2006-06-24 |
1649216151 | Lin Xiong | Radiology | 1601 Lamy Ln, Monroe, LA 71201-3735 | 2006-06-22 |
1962450155 | Mecklenburg Diagnostic Imaging LLC | Radiology | 1309 E Sunset Dr, Monroe, NC 28112-4324 | 2006-05-04 |
1336148436 | Mary Carolyn Pomeroy | Radiology | 600 Hospital Dr, Union Regional Medical Center, Monroe, NC 28112-6000 | 2005-07-20 |
Find all providers in MONROE |
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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.