STATE OF LOUISIANA (NPI# 1578950028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578950028 |
| Entity Type | Organization |
| Organization Name | STATE OF LOUISIANA |
| Other Organization Name | SOUTHEASTERN LOUISIANA SPORTS MEDICINE |
| Practice Address |
548 Western Ave Hammond LA 70402-0001 |
| Mailing Address |
Po Box 650850 Dept 1011 Dallas TX 75265-0850 |
| Practice Telephone | 9723674845 |
| Practice Fax Number | 9723673451 |
| Mailing Telephone | 8005559073 |
| Mailing Fax Number | 9723673452 |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-04-22 |
| Authorized Official Name | MOUZON BASS (AGENT) |
| Authorized Official Telephone | 9723674845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Southeastern Louisiana Sports Medicine | Doing Business As Name - Organization |
| Street Address |
548 WESTERN AVE |
| City | HAMMOND |
| State | LA |
| Zip Code | 70402-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164980801 | Jordan Moore | Student in an Organized Health Care Education/Training Program | 800 Galloway Drive, Hammond, LA 70402-0001 | 2019-03-12 |
| 1316404049 | Matthew L Blair | Student in an Organized Health Care Education/Training Program | 400 Mane Street 800 Galloway Drive, Hammond, LA 70402-0001 | 2019-02-28 |
| 1336603638 | L'nya Moore | Student in an Organized Health Care Education/Training Program | 400 Mane Street, Hammond, LA 70402-0001 | 2019-01-31 |
| 1306318738 | Louise D Billingsley | Clinical Nurse Specialist | 200 Tennessee Avenue, Hammond, LA 70402-0001 | 2018-12-25 |
| 1285119487 | Lisa W Magliolo | Registered Nurse | 15270 Paul Vega Drive, Hammond, LA 70402-0001 | 2018-10-03 |
| 1144723685 | Benjamen David Messina | Specialist/Technologist | Southeastern Louisiana University, Hammond, LA 70402-0001 | 2018-03-12 |
| 1699213645 | Erin Kennedy | Specialist/Technologist | 400 Tennessee Ave, Hammond, LA 70402-0001 | 2017-02-09 |
| 1477900298 | Nathan Quebedeaux | Specialist/Technologist | Slu 10309, Hammond, LA 70402-0001 | 2016-05-23 |
| 1437558178 | Megan Hetrick | Specialist/Technologist | 800 Galloway Dr, Hammond, LA 70402-0001 | 2014-08-19 |
| 1265844237 | Southeastern Louisiana University | Nurse Practitioner | Slu 10720, Hammond, LA 70402-0001 | 2014-05-27 |
| Find all providers in zip 70402 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568851962 | University of Louisiana of Monroe | Family Medicine | 308 Warhawk Way, Monroe, LA 71209-0001 | 2015-01-22 |
| 1497768147 | Rani G Whitfield | Family Medicine | 429 East Airport Dr., Suite 4, Baton Rouge, LA 70806 | 2006-08-14 |
| 1962474064 | Amanda Ruth Phillips-savoy | Family Medicine | 204 Energy Pkwy, Suite B, Lafayette, LA 70508-3816 | 2006-02-02 |
| 1538703335 | Center for Orthopaedics and Spine LLC | Family Medicine | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2019-11-05 |
| 1861881435 | Nicholls State University | Family Medicine | 906 E 1st St, Thibodaux, LA 70301-6701 | 2015-01-20 |
| 1295155778 | Alex Anderson | Family Medicine | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2014-04-23 |
| 1558658211 | Travis Steven Currie | Family Medicine | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2011-07-01 |
| 1700065323 | The Bond Group | Family Medicine | 913 S College Rd, Suite 106, Lafayette, LA 70503-3060 | 2007-10-31 |
| 1790983807 | Brian Joseph Lindenmayer | Family Medicine | 2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021 | 2007-07-10 |
| 1710184965 | The Bond Group, LLC | Family Medicine | 1101 S College Rd, Suite 201, Lafayette, LA 70503-3038 | 2007-06-29 |
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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.