OUR LADY OF THE LAKE PHYSICIAN GROUP, LLC (NPI# 1972052520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972052520 |
| Entity Type | Organization |
| Organization Name | OUR LADY OF THE LAKE PHYSICIAN GROUP, LLC |
| Practice Address |
1401 N Foster Dr Baton Rouge LA 70806-1818 |
| Mailing Address |
5000 Hennessy Blvd Baton Rouge LA 70808-4375 |
| Practice Telephone | 2259879095 |
| Practice Fax Number | 2259879096 |
| Mailing Telephone | 2257654281 |
| Mailing Fax Number | 2257655645 |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-09-23 |
| Authorized Official Name | JEFFREY D LIMBOCKER (REGIONAL CFO) |
| Authorized Official Telephone | 2257658550 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134152630 | Our Lady of The Lake Physician Group, LLC | Clinic/Center | 18740 Highway 22, Maurepas, LA 70449-3018 | 2006-07-08 |
| 1588062079 | Our Lady of The Lake Physician Group, LLC | Clinic/Center | 5439 Airline Hwy, Baton Rouge, LA 70805-1712 | 2014-12-15 |
| Street Address |
1401 N FOSTER DR |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70806-1818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871593533 | Sheila S. Perkins | Nurse Practitioner | 1401 N Foster Dr, Family Practice Clinic, Baton Rouge, LA 70806-1818 | 2005-07-26 |
| 1831605062 | Our Lady of The Lake Hospital | Pharmacy | 1401 N Foster Dr, Baton Rouge, LA 70806-1818 | 2017-12-26 |
| 1083071856 | Juliet Blades | Pharmacist | 1401 N Foster Dr, Baton Rouge, LA 70806-1818 | 2016-01-25 |
| 1174980940 | Jeffrey Bonaventure | Pharmacist | 1401 N Foster Dr, Baton Rouge, LA 70806-1818 | 2016-01-25 |
| 1174980064 | Adria Kerr | Pharmacist | 1401 N Foster Dr, Baton Rouge, LA 70806-1818 | 2016-01-22 |
| 1639580640 | Amanda Schittone | Nurse Practitioner | 1401 N Foster Dr, Baton Rouge, LA 70806 | 2014-05-13 |
| 1396184537 | Neva White Lipscomb | Nurse Practitioner | 1401 N Foster Dr, Baton Rouge, LA 70806-1818 | 2013-06-20 |
| 1669740239 | Michele Julia Musso | Nurse Practitioner | 1401 N Foster Dr, Baton Rouge, LA 70806-1818 | 2011-12-09 |
| 1942450945 | Samaki Sanders Green | Nurse Practitioner | 1401 N Foster Dr, Baton Rouge, LA 70806-1818 | 2008-09-25 |
| 1609034859 | Trucly Chung Vu | Podiatrist | 1401 N Foster Dr, Lsu Diabetes Foot Program, Baton Rouge, LA 70806-1818 | 2008-05-23 |
| Find all providers in the same location | ||||
| 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 | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568002442 | Sara Miller | Clinic/Center | 9602 Myrtle Ln, Baton Rouge, LA 70810-4238 | 2020-01-08 |
| 1831463470 | Beaumont Urgent Care Clinic | Clinic/Center | 2097 Beaumont Dr, Baton Rouge, LA 70806-1412 | 2012-02-29 |
| 1518250356 | Convenient Care LLC | Clinic/Center | 13686 Coursey Blvd, Baton Rouge, LA 70817-1303 | 2011-05-26 |
| 1831496793 | Baton Rouge Clinic, A Medical Corporation | Clinic/Center | 7479 Perkins Rd, Baton Rouge, LA 70808-4328 | 2011-02-11 |
| 1649596321 | Fast Lane of Central LLC | Clinic/Center | 11421 Sullivan Rd, Bldg B, Baton Rouge, LA 70818 | 2010-04-20 |
| 1295986438 | Convenient Care LLC | Clinic/Center | 123 Lee Drive, Baton Rouge, LA 70808 | 2008-10-07 |
| 1821181801 | Convenient Care LLC | Clinic/Center | 2380 Oneal Ln, Suite A, Baton Rouge, LA 70816-9315 | 2006-10-02 |
| 1497848477 | Convenient Care LLC | Clinic/Center | 8751 Sullivan Road, Baton Rouge, LA 70818-0000 | 2006-10-02 |
| 1356974281 | Ut East Texas Urgent Care Centers | Clinic/Center | 10319 Jefferson Hwy, Baton Rouge, LA 70809-2730 | 2020-02-19 |
| 1982152369 | Rapid Urgent Care, Inc. | Clinic/Center | 5207 Essen Ln, Suite 2, Baton Rouge, LA 70809-3565 | 2016-09-14 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70806 |
Please comment or provide details below to improve the information on OUR LADY OF THE LAKE PHYSICIAN GROUP, 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.