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PEDIATRIC SPECIALTY CLINIC
NPI 1093947905
Emergency Medicine - Pediatric Emergency Medicine in Baton Rouge, LA

Active since August 12, 2009
5000 HENNESSY BLVD, BATON ROUGE, LA 70808(225) 765-7163(225) 765-7164 Get Directions Write a Review

NPPES record last updated: April 15, 2011. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Pediatric Specialty Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC SPECIALTY CLINIC (NPI 1093947905) is a healthcare organization registered as a pediatric emergency medicine in Baton Rouge, Louisiana and active in the NPI registry since August 2009. The organization lists Jeffery D. Limbocker, Cfo, as its authorized official.

NPPES Registry Identity

NPI1093947905
Entity TypeOrganization
Primary Taxonomy207PP0204X
Legal Business NameOUR LADY OF THE LAKE HOSPITAL, INC
Location Address5000 HENNESSY BLVDBaton Rouge, LA 70808-4375
Mailing Address8415 Goodwood Blvd, Ste 105Baton Rouge, LA 70806-7851 · (225) 765-5727 · Fax (225) 765-4278
Phone(225) 765-7163
Fax(225) 765-7164
Organization SubpartYes
Authorized OfficialJeffery D. LimbockerCfo · (225) 765-6306
Enumeration DateAugust 12, 2009
Last NPPES UpdateApril 15, 2011
✔ NPI 1093947905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency Medicine · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207PP0204X
Definition
Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department.
5000 HENNESSY BLVD, Baton Rouge, LA 70808
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Other Names 1

Doing Business AsPediatric Specialty Clinic

Other Identifiers 3

Medicaid1447129LA
Medicare PIN5BD11
Medicaid08775372MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JESSICA LYNN BROUSSE NP
Nurse Practitioner
5000 HENNESSY BLVD
BATON ROUGE, LA 70808
East Baton Rouge Parish (225) 765-4050
CASEY M LEBLANC MPAS, PA-C
Physician Assistant
5000 HENNESSY BLVD
BATON ROUGE, LA 70808
East Baton Rouge Parish (225) 757-0552
DR. RAYMOND TUCKER PHD
Psychologist (Clinical)
5000 HENNESSY BLVD
BATON ROUGE, LA 70808
East Baton Rouge Parish (225) 765-6565
KEENAN JAMES BUIE
Student in an Organized Health Care Education/Training Program
5000 HENNESSY BLVD
BATON ROUGE, LA 70808
East Baton Rouge Parish (225) 281-0127
KEVIN PATRICK HAYNES JR. MD
Physical Medicine & Rehabilitation
5000 HENNESSY BLVD
BATON ROUGE, LA 70808
East Baton Rouge Parish (225) 765-8987
TAHA AHMED MD
Hospitalist
5000 HENNESSY BLVD
BATON ROUGE, LA 70808
East Baton Rouge Parish (225) 765-4050
DR. JON RICHARD JACKSON M.D.
Internal Medicine
5000 HENNESSY BLVD
BATON ROUGE, LA 70808
East Baton Rouge Parish (225) 765-4050
SERENA M AUNON-CHANCELLOR MD
Internal Medicine
5000 HENNESSY BLVD
BATON ROUGE, LA 70808
East Baton Rouge Parish (225) 757-4080

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Our Lady Of The Lake Hospital, Inc's NPI number?

The NPI number for Our Lady Of The Lake Hospital, Inc is 1093947905. It was assigned to this organization in the NPPES registry on August 12, 2009. The provider is doing business as Pediatric Specialty Clinic.

Where is Our Lady Of The Lake Hospital, Inc located?

Our Lady Of The Lake Hospital, Inc is located at 5000 Hennessy Blvd, Baton Rouge, LA 70808. The listed phone number is (225) 765-7163.

What is Our Lady Of The Lake Hospital, Inc's specialty?

The primary specialty registered for this NPI is Emergency Medicine, specializing in Pediatric Emergency Medicine, with taxonomy code 207PP0204X.

When was this NPI record last updated?

The NPPES record for Our Lady Of The Lake Hospital, Inc was last updated on April 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.