| St. Tammany Parish Hospital Service District No 1 | |
| 
					82525 Highway 25 Folsom LA 70437-3116  | |
| (985) 839-9895 | |
| (985) 839-9884 | 
| Full Name | St. Tammany Parish Hospital Service District No 1 | 
|---|---|
| Speciality | Family Medicine | 
| Location | 82525 Highway 25, Folsom, Louisiana | 
| Authorized Official Name and Position | Joan Coffman (PRESIDENT/CEO) | 
| Authorized Official Contact | 9858984000 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| St. Tammany Parish Hospital Service District No 1 Po Box 669379 Dallas TX 75266-9379 Ph: (985) 898-4493  | St. Tammany Parish Hospital Service District No 1 82525 Highway 25 Folsom LA 70437-3116 Ph: (985) 839-9895  | 
| NPI Number | 1275539363 | 
|---|---|
| Provider Enumeration Date | 06/22/2005 | 
| Last Update Date | 12/06/2022 | 
| Medicare PECOS PAC ID | 0749273761 | 
|---|---|
| Medicare Enrollment ID | O20040406000728 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1275539363 | NPI | - | NPPES | 
| 1446017 | Medicaid | LA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
| Provider Name | Lasandra Barton | 
|---|---|
| Provider Type | Practitioner - Pulmonary Disease | 
| Provider Identifiers | NPI Number: 1699777615 PECOS PAC ID: 8628977063 Enrollment ID: I20040106000128  | 
| Provider Name | Hamid Salam | 
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) | 
| Provider Identifiers | NPI Number: 1346287737 PECOS PAC ID: 3173413481 Enrollment ID: I20040319000047  | 
| Provider Name | Christopher M Foret | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1245251602 PECOS PAC ID: 2466445499 Enrollment ID: I20040406000828  | 
| Provider Name | Libeau J Berthelot | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1023039476 PECOS PAC ID: 7618960642 Enrollment ID: I20040406000844  | 
| Provider Name | Mark L James | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1821019282 PECOS PAC ID: 3577556513 Enrollment ID: I20040406000890  | 
| Provider Name | Leslie Copeland Dominguez | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1124059639 PECOS PAC ID: 8628044914 Enrollment ID: I20040908000867  | 
| Provider Name | Stephen G Mixon | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1386610608 PECOS PAC ID: 5496710667 Enrollment ID: I20041130000207  | 
| Provider Name | Michael W Carpenter | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1053312231 PECOS PAC ID: 6709839368 Enrollment ID: I20050224000027  | 
| Provider Name | Ludwig C Heintz | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1295736411 PECOS PAC ID: 2163475724 Enrollment ID: I20050224000031  | 
| Provider Name | Vernon K Palmisano | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1851347710 PECOS PAC ID: 0345270914 Enrollment ID: I20050815000398  | 
| Provider Name | Juzar Ali | 
|---|---|
| Provider Type | Practitioner - Pulmonary Disease | 
| Provider Identifiers | NPI Number: 1508887522 PECOS PAC ID: 0941226732 Enrollment ID: I20051020000801  | 
| Provider Name | George F Isa | 
|---|---|
| Provider Type | Practitioner - Interventional Cardiology | 
| Provider Identifiers | NPI Number: 1588627533 PECOS PAC ID: 5890881478 Enrollment ID: I20071011000597  | 
| Provider Name | David S Cressy | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1437108321 PECOS PAC ID: 1355243874 Enrollment ID: I20071031000139  | 
| Provider Name | Donald A Kuebel | 
|---|---|
| Provider Type | Practitioner - Pulmonary Disease | 
| Provider Identifiers | NPI Number: 1669421772 PECOS PAC ID: 2466351556 Enrollment ID: I20080222000483  | 
| Provider Name | Ricardo E Blanco | 
|---|---|
| Provider Type | Practitioner - Pulmonary Disease | 
| Provider Identifiers | NPI Number: 1356390371 PECOS PAC ID: 1456253970 Enrollment ID: I20080410000774  | 
| Provider Name | Paul Foster Stahls | 
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology | 
| Provider Identifiers | NPI Number: 1508057530 PECOS PAC ID: 7315011681 Enrollment ID: I20080805000147  | 
| Provider Name | John H Verhulst | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1053312223 PECOS PAC ID: 5294801437 Enrollment ID: I20080911000461  | 
| Provider Name | Sandra R Almerico | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1558502237 PECOS PAC ID: 3678624921 Enrollment ID: I20090625000520  | 
| Provider Name | Robert Brinkman | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1881614865 PECOS PAC ID: 9830225572 Enrollment ID: I20100405000003  | 
| Provider Name | Richard Casey | 
|---|---|
| Provider Type | Practitioner - Pulmonary Disease | 
| Provider Identifiers | NPI Number: 1326097759 PECOS PAC ID: 6800798323 Enrollment ID: I20100706000254  | 
| Provider Name | Roch Hontas | 
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery | 
| Provider Identifiers | NPI Number: 1659466845 PECOS PAC ID: 1153493903 Enrollment ID: I20100805000976  | 
| Provider Name | Mark James Hontas | 
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery | 
| Provider Identifiers | NPI Number: 1417042706 PECOS PAC ID: 1153366349 Enrollment ID: I20100805001039  | 
| Provider Name | Wendy A Pratt | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1225021207 PECOS PAC ID: 4587652730 Enrollment ID: I20101124000492  | 
| Provider Name | Mary M Scheyd | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1144415605 PECOS PAC ID: 4486743150 Enrollment ID: I20110426000744  | 
| Provider Name | Melissa A Varnado | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1649551292 PECOS PAC ID: 9234301292 Enrollment ID: I20111017000629  | 
| Provider Name | Anne K Thiel | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1083990139 PECOS PAC ID: 4284800608 Enrollment ID: I20120105000548  | 
| Provider Name | Bekir Melek | 
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) | 
| Provider Identifiers | NPI Number: 1114033917 PECOS PAC ID: 1658460886 Enrollment ID: I20120828000643  | 
| Provider Name | Maximino Nmi Martell | 
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) | 
| Provider Identifiers | NPI Number: 1598049785 PECOS PAC ID: 6002052610 Enrollment ID: I20130425000647  | 
| Provider Name | Irene S Caillouet | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1740440585 PECOS PAC ID: 6800036138 Enrollment ID: I20131216000822  | 
| Provider Name | Kara E Ward | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1073756227 PECOS PAC ID: 1951534866 Enrollment ID: I20140430000997  | 
| Provider Name | Chad Benjamin Vanasselberg | 
|---|---|
| Provider Type | Practitioner - Pulmonary Disease | 
| Provider Identifiers | NPI Number: 1265630826 PECOS PAC ID: 3173746583 Enrollment ID: I20140603000496  | 
| Provider Name | Georges El Khoury Antoun | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1265621130 PECOS PAC ID: 3971735275 Enrollment ID: I20140805000402  | 
| Provider Name | Jacob B Daigle | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1306071469 PECOS PAC ID: 7012134083 Enrollment ID: I20140814002153  | 
| Provider Name | Mark Gregory Jones | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1215165303 PECOS PAC ID: 7113175803 Enrollment ID: I20141201001798  | 
| Provider Name | Mccall Guyton Mcdaniel | 
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery | 
| Provider Identifiers | NPI Number: 1760706782 PECOS PAC ID: 7719205350 Enrollment ID: I20160701000090  | 
| Provider Name | Patrick Henderson Wainright | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1871809004 PECOS PAC ID: 5294013413 Enrollment ID: I20161024000072  | 
| Provider Name | Joey Lamartina | 
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery | 
| Provider Identifiers | NPI Number: 1962723049 PECOS PAC ID: 3678706124 Enrollment ID: I20170103001062  | 
| Provider Name | Nicole Sesser | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1912451139 PECOS PAC ID: 0547541617 Enrollment ID: I20170103001649  | 
| Provider Name | Caroline H Barkerding | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1225578313 PECOS PAC ID: 2668759614 Enrollment ID: I20170501001709  | 
| Provider Name | William G Terral | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1023303450 PECOS PAC ID: 8921228982 Enrollment ID: I20170824000669  | 
| Provider Name | Gregory Jacob | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1629430269 PECOS PAC ID: 6608165956 Enrollment ID: I20180801001794  | 
| Provider Name | Russell Joseph Reed | 
|---|---|
| Provider Type | Practitioner - Interventional Cardiology | 
| Provider Identifiers | NPI Number: 1487852034 PECOS PAC ID: 9638347214 Enrollment ID: I20180801002489  | 
| Provider Name | Rachele A Gibson | 
|---|---|
| Provider Type | Practitioner - Pulmonary Disease | 
| Provider Identifiers | NPI Number: 1932344116 PECOS PAC ID: 0244417772 Enrollment ID: I20181017000248  | 
| Provider Name | Laura Read | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1619431830 PECOS PAC ID: 1557601911 Enrollment ID: I20190321000164  | 
| Provider Name | Karmynah M Helaire | 
|---|---|
| Provider Type | Practitioner - General Practice | 
| Provider Identifiers | NPI Number: 1205254158 PECOS PAC ID: 7810116035 Enrollment ID: I20190605000274  | 
| Provider Name | Karolina Diana Ruthner | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1205486644 PECOS PAC ID: 8022443746 Enrollment ID: I20200127000853  | 
| Provider Name | Kira Gilmore Smith | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1013553577 PECOS PAC ID: 7911328018 Enrollment ID: I20200527002840  | 
| Provider Name | Jennifer S Roy | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1780211607 PECOS PAC ID: 5092137950 Enrollment ID: I20200623000032  | 
| Provider Name | Kelly D Crim | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1841838125 PECOS PAC ID: 9739506155 Enrollment ID: I20200831003392  | 
| Provider Name | Paula Rene Lee | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1588294995 PECOS PAC ID: 0941620694 Enrollment ID: I20201019000652  | 
| Provider Name | Angela Buonagura | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1780676841 PECOS PAC ID: 3072637024 Enrollment ID: I20210111001274  | 
| Provider Name | Molly Marie Peck | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1548849680 PECOS PAC ID: 2668880287 Enrollment ID: I20210421000332  | 
| Provider Name | Clifford E Coile | 
|---|---|
| Provider Type | Practitioner - Pulmonary Disease | 
| Provider Identifiers | NPI Number: 1881073062 PECOS PAC ID: 9739494600 Enrollment ID: I20210614001630  | 
| Provider Name | Sarah H Bourgeois | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1598410482 PECOS PAC ID: 1759776065 Enrollment ID: I20220324000522  | 
| Provider Name | Taylor K Brooks | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1447906037 PECOS PAC ID: 0648667725 Enrollment ID: I20220419001948  | 
| Provider Name | Victoria R Blossman | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1073075008 PECOS PAC ID: 7719213636 Enrollment ID: I20220619000022  | 
| Provider Name | Hafiz Ghafoor | 
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology | 
| Provider Identifiers | NPI Number: 1497049852 PECOS PAC ID: 5890915706 Enrollment ID: I20220904000092  | 
| Provider Name | Stefan Sicinschi | 
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) | 
| Provider Identifiers | NPI Number: 1942663331 PECOS PAC ID: 0244526341 Enrollment ID: I20220906001718  | 
| Provider Name | James Matthew Noel | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1467178681 PECOS PAC ID: 2365810454 Enrollment ID: I20221121002584  | 
| Provider Name | Jonathan Brent Moss | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1447784103 PECOS PAC ID: 7416224035 Enrollment ID: I20230818000561  | 
| Provider Name | Christine Fields | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1669259032 PECOS PAC ID: 1052761699 Enrollment ID: I20231222001905  | 
| Provider Name | Matthew Webb | 
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery | 
| Provider Identifiers | NPI Number: 1033564687 PECOS PAC ID: 9133412307 Enrollment ID: I20240213002501  | 
| Provider Name | Breanna L Shenk | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1659051621 PECOS PAC ID: 0941647432 Enrollment ID: I20240416003641  | 
| Provider Name | Morgan Laurent Cookmeyer | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1801355052 PECOS PAC ID: 1254667447 Enrollment ID: I20240828001333  | 
| Provider Name | Christopher Porter | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1639674609 PECOS PAC ID: 3870843980 Enrollment ID: I20240911002276  |