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OUR LADY OF THE LAKE PHYSICIAN GROUP LLC
NPI 1174662035
Family Medicine in New Roads, LA

Active since February 06, 2007CLIA 19D0934306 · Microscopy
230 ROBERTS DR, SUITE H, NEW ROADS, LA 70760(225) 638-7033(225) 638-7034 Get Directions Write a Review

NPPES record last updated: December 10, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Our Lady Of The Lake Physician Group Llc NPPES

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

OUR LADY OF THE LAKE PHYSICIAN GROUP LLC (NPI 1174662035) is a healthcare organization registered as a family medicine in New Roads, Louisiana and active in the NPI registry since February 2007. The organization holds a CLIA Microscopy certificate valid through October 2, 2027 and lists Elona Sharbaugh, Vp Physician Practices, as its authorized official.

NPPES Registry Identity

NPI1174662035
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameOUR LADY OF THE LAKE PHYSICIAN GROUP LLC
Location Address230 ROBERTS DR, SUITE HNew Roads, LA 70760-2661
Mailing Address2051 Silverside Dr, Suite 120Baton Rouge, LA 70808-9005 · (225) 765-4226 · Fax (225) 765-9244
Phone(225) 638-7033
Fax(225) 638-7034
Organization SubpartYesParent: Our Lady Of The Lake Hospital Inc
Authorized OfficialElona SharbaughVp Physician Practices · (225) 490-8806
Enumeration DateFebruary 6, 2007
Last NPPES UpdateDecember 10, 2012
✔ NPI 1174662035 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPhysician AssistantTaxonomy 363A00000X
230 ROBERTS DR, New Roads, LA 70760
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Other Identifiers 2

Medicaid1447501LA
Medicare OSCAR/certification193855LA

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 MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 19D0934306

Our Lady Of The Lake Physician Group-New Roads · New Roads, LA
Active · expires Oct 2, 2027
CLIA Number19D0934306
Laboratory TypePhysician Office
Certificate Effective DateOctober 3, 2025
Certificate Expiration DateOctober 2, 2027
Laboratory DirectorBrian Leblanc
Laboratory Phone(225) 765-5500
Laboratory LocationOur Lady Of The Lake Physician Group-New Roads310 Durel Dr, New Roads, LA 70760
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 9

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

JOE M. GANNON, M.D. A PROFESSIONAL MEDICAL CORP
Ophthalmology
230 ROBERTS DR, SUITE J
NEW ROADS, LA 70760
Pointe Coupee Parish (225) 718-3764
JASON JOSEPH PICARD M.D.
Internal Medicine
230 ROBERTS DR, SUITE I
NEW ROADS, LA 70760
Pointe Coupee Parish (225) 638-4885
DONALD W DOUCET MD AND ASSOCIATES LLC
Internal Medicine
230 ROBERTS DR, SUITE I
NEW ROADS, LA 70760
Pointe Coupee Parish (225) 638-4585
COASTAL FOOT CLINIC, A P.C.
Podiatrist
230 ROBERTS DR, SUITE G
NEW ROADS, LA 70760
Pointe Coupee Parish (225) 638-6640
OUR LADY OF THE LAKE PHYSICIAN GROUP LLC
Family Medicine
230 ROBERTS DR, SUITE B
NEW ROADS, LA 70760
Pointe Coupee Parish (225) 638-8661
DONALD WILLIAM DOUCET M.D.
Internal Medicine
230 ROBERTS DR, SUITE I
NEW ROADS, LA 70760
Pointe Coupee Parish (225) 638-4885
COASTAL FOOT CLINIC INC
Podiatrist
230 ROBERTS DR, SUITE G
NEW ROADS, LA 70760
Pointe Coupee Parish (225) 638-6640
ASHLEY DOUCET BORDELON M.D.
Internal Medicine
230 ROBERTS DR, SUITE I
NEW ROADS, LA 70760
Pointe Coupee Parish (225) 638-4585

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 Physician Group LLC's NPI number?

The NPI number for Our Lady Of The Lake Physician Group LLC is 1174662035. It was assigned to this organization in the NPPES registry on February 6, 2007.

Where is Our Lady Of The Lake Physician Group LLC located?

Our Lady Of The Lake Physician Group LLC is located at 230 Roberts Dr Suite H, New Roads, LA 70760. The listed phone number is (225) 638-7033.

What is Our Lady Of The Lake Physician Group LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Our Lady Of The Lake Physician Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 19D0934306) is associated with this NPI, valid through October 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Our Lady Of The Lake Physician Group LLC was last updated on December 10, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.