Provider Demographics
| NPI: | 1083655567 |
|---|---|
| Name: | UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATION |
| Entity type: | Organization |
| Organization Name: | UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATION |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CFO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CHRISTINE |
| Authorized Official - Middle Name: | M |
| Authorized Official - Last Name: | BOND |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 504-702-4380 |
| Mailing Address - Street 1: | 2000 CANAL ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | NEW ORLEANS |
| Mailing Address - State: | LA |
| Mailing Address - Zip Code: | 70112-3018 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 504-702-2081 |
| Mailing Address - Fax: | 504-702-2118 |
| Practice Address - Street 1: | 2000 CANAL ST |
| Practice Address - Street 2: | |
| Practice Address - City: | NEW ORLEANS |
| Practice Address - State: | LA |
| Practice Address - Zip Code: | 70112-3018 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 504-702-2081 |
| Practice Address - Fax: | 504-702-2118 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-06-08 |
| Last Update Date: | 2024-02-05 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
| No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
| No | 207PE0005X | Allopathic & Osteopathic Physicians | Emergency Medicine | Undersea and Hyperbaric Medicine | Group - Multi-Specialty |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
| No | 207RS0012X | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | Group - Multi-Specialty |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Group - Multi-Specialty | |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| LA | 1799998 | Medicaid | |
| LA | 1444766 | Medicaid |