FERTILE CRESCENT PEDIATRICS, LLC (NPI# 1902131667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902131667 |
| Entity Type | Organization |
| Organization Name | FERTILE CRESCENT PEDIATRICS, LLC |
| Practice Address |
730 Colonial Dr Suite B Baton Rouge LA 70806-6536 |
| Practice Telephone | 2259247343 |
| Practice Fax Number | 2259247347 |
| Mailing Telephone | 2259247343 |
| Mailing Fax Number | 2259247347 |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2009-10-13 |
| Authorized Official Name | DR. BRIAN DESPINASSE II (CEO) |
| Authorized Official Telephone | 2259247343 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 023350 | LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1490903 | 05 |
| Street Address |
730 COLONIAL DR SUITE B |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70806-6536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124569397 | Children's International, LLC | Clinic/Center | 730 Colonial Dr, Baton Rouge, LA 70806-6536 | 2017-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467064790 | Horizon Network LLC | Community/Behavioral Health | 921 Lobdell Blvd Suite D, Baton Rouge, LA 70806 | 2020-08-18 |
| 1093324220 | Raghu Rudraraju | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard Baton Rouge General Mid City Medi, Suite 130, Baton Rouge, LA 70806 | 2020-07-23 |
| 1619595584 | Brown's Pharmacy, LLC | Pharmacy | 1718 North Foster Drive, Suite B, Baton Rouge, LA 70806 | 2020-07-08 |
| 1497374847 | Yara Mouawad | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Suite 130, Baton Rouge, LA 70806 | 2020-04-15 |
| 1396364527 | Sai Samyuktha Bandaru | Student in an Organized Health Care Education/Training Program | Brg Mid City Medicine Clinic, 3401 North Boulevard, Sui, Baton Rouge, LA 70806 | 2020-04-08 |
| 1588299812 | Iraneeka S Gustave | Peer Specialist | Kelwood Ave, 8326 Kelwood Ave, Baton Rouge, LA 70806 | 2020-03-06 |
| 1518522192 | Silpita Katragadda | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Brg Midcity Medicine Clinic, Suite 130, Baton Rouge, LA 70806 | 2019-05-08 |
| 1437713997 | Dental Solutions, LLC | Dentist | 5629 Government St, Baton Rouge, LA 70806 | 2019-04-30 |
| 1699249516 | Shea Lafountain | Counselor | 624 Connell's Park Lane, Baton Rouge, LA 70806 | 2019-01-14 |
| 1033682802 | Genesis Specialty Groups, LLC | Clinic/Center | 778 Chevelle Drive, Baton Rouge, LA 70806 | 2019-01-04 |
| Find all providers in zip 70806 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679096416 | Baton Rouge General Medical Center | Clinic/Center | 8490 Picardy Ave Ste 600, Baton Rouge, LA 70809 | 2017-07-24 |
| 1326441643 | Health Care Centers In Schools | Clinic/Center | 9147 Elmgrove Garden Dr, Baton Rouge, LA 70807-4308 | 2014-10-01 |
| 1073921730 | Baton Rouge Chiropractic and Nutrition, LLC | Clinic/Center | 4137 S Sherwood Frst, Suite 110, Baton Rouge, LA 70816-4377 | 2014-07-25 |
| 1801143607 | Aids Healthcare Foundation | Clinic/Center | 8281 Goodwood Blvd, Suite D, Baton Rouge, LA 70806-7742 | 2012-08-10 |
| 1710287057 | James A Van Hook IIi Phd LLC | Clinic/Center | 1200 S Acadian Trwy, Baton Rouge, LA 70806-6900 | 2010-11-02 |
| 1003135633 | Charlie H Bridges Md, Facs | Clinic/Center | 7777 Hennessy Blvd Ste 608, Baton Rouge, LA 70808-4366 | 2010-05-21 |
| 1699097907 | Health Care Centers In Schools | Clinic/Center | 10100 Goodwood Blvd, Baton Rouge, LA 70815-4521 | 2010-02-28 |
| 1053633446 | Health Care Centers In Schools | Clinic/Center | 1676 Glasgow Ave, Baton Rouge, LA 70808-8631 | 2010-02-25 |
| 1619205242 | Jane Olson Md | Clinic/Center | 8440 Bluebonnet Blvd, Suite B, Baton Rouge, LA 70810-2978 | 2009-11-19 |
| 1679753982 | Daniel I Dial Md Apmc | Clinic/Center | 10880 Joor Rd, Baton Rouge, LA 70818-3909 | 2007-11-05 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70806 |
Please comment or provide details below to improve the information on FERTILE CRESCENT PEDIATRICS, LLC.
| 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.