OUR LADY OF THE LAKE HOSPITAL INC PEDIATRIC PULMONARY CLINIC
NPI 1972645216
Pediatrics - Pediatric Pulmonology in Baton Rouge, LA

Active since February 13, 2007CLIA 19D1103464 · Waiver
7777 HENNESSY BLVD, PLAZA 1 SUITE 406, BATON ROUGE, LA 70810(225) 765-3456(225) 765-1899 Get Directions Write a Review

NPPES record last updated: May 19, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Our Lady Of The Lake Hospital Inc Pediatric Pulmonary Clinic NPPES

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

OUR LADY OF THE LAKE HOSPITAL INC PEDIATRIC PULMONARY CLINIC (NPI 1972645216) is a healthcare organization registered as a pediatric pulmonology in Baton Rouge, Louisiana and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through August 10, 2027 and lists Tamara White, Director Of Business Services, as its authorized official.

NPPES Registry Identity

NPI1972645216
Entity TypeOrganization
Primary Taxonomy2080P0214X
Legal Business NameOUR LADY OF THE LAKE REGIONAL MEDICA
Location Address7777 HENNESSY BLVD, PLAZA 1 SUITE 406Baton Rouge, LA 70810
Mailing Address8415 Goodwood Blvd, Suite 105Baton Rouge, LA 70806 · (225) 413-4361 · Fax (225) 765-4062
Fax(225) 765-1899
Organization SubpartNo
Authorized OfficialTamara WhiteDirector Of Business Services · (225) 765-4251
Enumeration DateFebruary 13, 2007
Last NPPES UpdateMay 19, 2011
NPI 1972645216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatrics · Pediatric PulmonologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0214X
Definition

A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.

7777 HENNESSY BLVD, Baton Rouge, LA 70810

Other Names 1

Doing Business AsOur Lady Of The Lake Hospital Inc Pediatric Pulmonary Clinic

Other Identifiers 2

Medicare ID-Type Unspecified5H580LA
Medicaid1445584LA

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

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 of Waiver 19D1103464

Our Lady Of The Lake Pediatric Academic Clinic · Baton Rouge, LA
Active · expires Aug 10, 2027
CLIA Number19D1103464
Laboratory TypePhysician Office
Certificate Effective DateAugust 11, 2025
Certificate Expiration DateAugust 10, 2027
Laboratory DirectorMikki Bouquet
Laboratory Phone(225) 765-3385
Laboratory LocationOur Lady Of The Lake Pediatric Academic Clinic8415 Goodwood Boulevard, Suite 202, Baton Rouge, LA 70806
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

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 Regional Medica's NPI number?

The NPI number for Our Lady Of The Lake Regional Medica is 1972645216. It was assigned to this organization in the NPPES registry on February 13, 2007. The provider is doing business as Our Lady Of The Lake Hospital Inc Pediatric Pulmonary Clinic.

Where is Our Lady Of The Lake Regional Medica located?

Our Lady Of The Lake Regional Medica is located at 7777 Hennessy Blvd Plaza 1 Suite 406, Baton Rouge, LA 70810. The listed phone number is (225) 765-3456.

What is Our Lady Of The Lake Regional Medica's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Pulmonology, with taxonomy code 2080P0214X.

Does Our Lady Of The Lake Regional Medica hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 19D1103464) is associated with this NPI, valid through August 10, 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 Regional Medica was last updated on May 19, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.