C&M MEDICAL SERVICES-ST ELIZABETH LLC (NPI# 1639474257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639474257 |
| Entity Type | Organization |
| Organization Name | C&M MEDICAL SERVICES-ST ELIZABETH LLC |
| Practice Address |
1125 West Louisiana Highway 30 Gonzales LA 70737 |
| Mailing Address |
3223 8th St Floor 3 Metairie LA 70002-1623 |
| Practice Telephone | 2256475000 |
| Practice Fax Number | 2256476066 |
| Mailing Telephone | 5048337770 |
| Mailing Fax Number | 5048334025 |
| Enumeration Date | 2011-01-12 |
| Last Update Date | 2012-01-09 |
| Authorized Official Name | DR. CRIS MANDRY (PRESIDENT) |
| Authorized Official Telephone | 5048337770 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
017058 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | BC/BS OF LA | J3181 | 01 |
| Street Address |
1125 WEST LOUISIANA HIGHWAY 30 |
| City | GONZALES |
| State | LA |
| Zip Code | 70737 |
| 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 | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639662539 | Doctor By Video,llc | Emergency Medicine | 1700 Central Blvd, Harvey, LA 70058-3288 | 2018-06-14 |
| 1780028175 | Wayne Thomas Robichaux | Emergency Medicine | 12 Muirfield Dr, La Place, LA 70068-1632 | 2013-04-29 |
| 1972705333 | Isaac Freeborn | Emergency Medicine | 1507 E Whatley Rd, Oakdale, LA 71463-2318 | 2007-06-05 |
| 1609097898 | Wesley Blake Vanderlan | Emergency Medicine | 400 S Chenier Dr, Madisonville, LA 70447-9389 | 2007-05-02 |
| 1801945936 | Louis Christopher Benjamin IIi | Emergency Medicine | 18961 Santa Maria Dr, Baton Rouge, LA 70809-6765 | 2007-01-09 |
| 1134235989 | Victor E Tuckler | Emergency Medicine | 639 Gelpi Ave, Jefferson, LA 70121-1527 | 2006-08-22 |
| 1710903059 | C & M Medical Services, Inc. | Emergency Medicine | 2450 Severn Ave Ste 205, Metairie, LA 70001 | 2006-07-13 |
| 1720014392 | Huey August Seyfarth Jr. | Emergency Medicine | 1424 Sherwood Forest Blvd, Baton Rouge, LA 70815-5332 | 2006-06-24 |
| 1073554010 | Gina Luisa Greco-angelopoulos | Emergency Medicine | 2640 Country Club Rd, Suite 400, Lake Charles, LA 70605-5912 | 2006-06-09 |
| 1841245842 | William R. Wise | Emergency Medicine | 1121 Gatewood Circle, Shreveport, LA 71106 | 2006-05-24 |
| 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.