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MARY BIRD PERKINS CANCER CENTER MEDICAID GROUP
NPI 1225274483
Radiology - Therapeutic Radiology in Baton Rouge, LA

Active since December 18, 2008CLIA Certified · 2 labs
4950 ESSEN LN, BATON ROUGE, LA 70809(225) 767-0847(225) 766-0218 Get Directions Write a Review

NPPES record last updated: November 17, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary Bird Perkins Cancer Center Medicaid Group NPPES

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

MARY BIRD PERKINS CANCER CENTER MEDICAID GROUP (NPI 1225274483) is a healthcare organization registered as a therapeutic radiology in Baton Rouge, Louisiana and active in the NPI registry since December 2008. The organization holds 2 active CLIA laboratory certificates and lists Paul R. Nowacki, Cfo, as its authorized official.

NPPES Registry Identity

NPI1225274483
Entity TypeOrganization
Primary Taxonomy2085R0203X
Legal Business NameMARY BIRD PERKINS CANCER CENTER
Location Address4950 ESSEN LNBaton Rouge, LA 70809-3738
Mailing Address4950 Essen LnBaton Rouge, LA 70809-3738 · (225) 767-0847 · Fax (225) 766-0218
Phone(225) 767-0847
Fax(225) 766-0218
Organization SubpartNo
Authorized OfficialPaul R. NowackiCfo · (225) 215-1223
Enumeration DateDecember 18, 2008
Last NPPES UpdateNovember 17, 2023
NPPES CertifiedNovember 17, 2023
✔ NPI 1225274483 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Therapeutic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0203X
Definition
Therapeutic Radiology certificate name was changed to Radiation Oncology. Use Radiation Oncology.
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
4950 ESSEN LN, Baton Rouge, LA 70809
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Other Names 1

Other NameMary Bird Perkins Cancer Center Medicaid Group

CLIA Laboratory Certificates CMS CLIA 2

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 of Waiver 19D0886998

Mary Bird Perkins Cancer Center · Baton Rouge, LA
Active · expires Jun 1, 2028
CLIA Number19D0886998
Laboratory TypeOther
Certificate Effective DateJune 2, 2026
Certificate Expiration DateJune 1, 2028
Laboratory DirectorSheldon Johnson
Laboratory Phone(225) 767-0847
Laboratory LocationMary Bird Perkins Cancer Center4950 Essen Lane, Baton Rouge, LA 70809
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 19D2278912

Mary Bird Perkins · Baton Rouge, LA
Active · expires Feb 20, 2028
CLIA Number19D2278912
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateFebruary 21, 2026
Certificate Expiration DateFebruary 20, 2028
Laboratory DirectorDr. Anthony M. Harton
Laboratory Phone(225) 215-0230
Laboratory LocationMary Bird Perkins4950 Essen Lane, Suite 300, Baton Rouge, LA 70809
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

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.

MRS. KATHRYN GRANGER OLIVIER RDN, LDN
Dietitian, Registered (Nutrition, Oncology)
4950 ESSEN LN
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 521-1216
DR. DAVID SAM HANSON MD
Internal Medicine (Hematology & Oncology)
4950 ESSEN LN, SUITE 500
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 767-1311
DUSTIN DAVID DENICOLA N.P.
Nurse Practitioner (Adult Health)
4950 ESSEN LN, SUITE 300
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 490-8882
MS. MARTHA A BROUSSARD CRNA
Nurse Anesthetist, Certified Registered
4950 ESSEN LN, REGIONAL EYE SURGERY CENTER
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 214-6688
AULDYN FONTAINE HIRSCHEY N.P.
Nurse Practitioner (Adult Health)
4950 ESSEN LN, SUITE 300
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 757-0343
DR. DEBORAH ALISON ABERNATHY MD
Internal Medicine (Hematology & Oncology)
4950 ESSEN LN, SUITE 300
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 757-0343
JINGYA WANG M.D.
Radiology (Radiation Oncology)
4950 ESSEN LN
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 767-0847
OUR LADY OF THE LAKE PHYSICIAN GROUP LLC
Internal Medicine (Hematology & Oncology)
4950 ESSEN LN
BATON ROUGE, LA 70809
East Baton Rouge Parish (225) 767-1311

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 Mary Bird Perkins Cancer Center's NPI number?

The NPI number for Mary Bird Perkins Cancer Center is 1225274483. It was assigned to this organization in the NPPES registry on December 18, 2008. The provider is also known as Mary Bird Perkins Cancer Center Medicaid Group.

Where is Mary Bird Perkins Cancer Center located?

Mary Bird Perkins Cancer Center is located at 4950 Essen Ln, Baton Rouge, LA 70809. The listed phone number is (225) 767-0847.

What is Mary Bird Perkins Cancer Center's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Therapeutic Radiology, with taxonomy code 2085R0203X.

Does Mary Bird Perkins Cancer Center hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Mary Bird Perkins Cancer Center was last updated on November 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.