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DESTREHAN MEDICAL CLINIC
NPI 1790876019
Clinic/Center - Primary Care in Destrehan, LA

Active since September 28, 2006
12604 RIVER RD, DESTREHAN, LA 70047(985) 764-0439(985) 725-1464 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Aug 22, 2020 (2 updates tracked since 2020).

About Destrehan Medical Clinic NPPES

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

DESTREHAN MEDICAL CLINIC (NPI 1790876019) is a healthcare organization registered as a primary care in Destrehan, Louisiana and active in the NPI registry since September 2006. The organization lists Chemmale Jayakrishnan, President/doctor, as its authorized official.

NPPES Registry Identity

NPI1790876019
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameDESTREHAN MEDICAL CLINIC
Location Address12604 RIVER RDDestrehan, LA 70047-5306
Mailing Address12604 River RdDestrehan, LA 70047-5306 · (985) 764-0439 · Fax (985) 725-1464
Phone(985) 764-0439
Fax(985) 725-1464
Organization SubpartNo
Authorized OfficialChemmale JayakrishnanPresident/doctor · (985) 785-2045
Enumeration DateSeptember 28, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1790876019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
12604 RIVER RD, Destrehan, LA 70047
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Other Identifiers 1

Medicaid1798703LA

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 Destrehan Medical Clinic's NPI number?

The NPI number for Destrehan Medical Clinic is 1790876019. It was assigned to this organization in the NPPES registry on September 28, 2006.

Where is Destrehan Medical Clinic located?

Destrehan Medical Clinic is located at 12604 River Rd, Destrehan, LA 70047. The listed phone number is (985) 764-0439.

What is Destrehan Medical Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Destrehan Medical Clinic was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.