TIMOTHY J PELLEGRIN (NPI# 1134160815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134160815 |
| Entity Type | Individual |
| Full Name | TIMOTHY J PELLEGRIN |
| Credential | PMHNP-BC |
| Practice Address |
1014 W Tunnel Blvd Houma LA 70360-4050 |
| Mailing Address |
1115 Weber Street Franklin LA 70538-4124 |
| Practice Telephone | 9858511717 |
| Practice Fax Number | 9858683839 |
| Mailing Telephone | 3378282550 |
| Mailing Fax Number | 3373552335 |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2019-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APO4222 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1152919 | 05 | |
| LA | MEDICARE NUMBER | 4C669 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013485432 | Timothy Pellegrin | Social Worker | 180 S Broadway Ste 401, White Plains, NY 10605-1820 | 2018-11-02 |
| Street Address |
1014 W TUNNEL BLVD |
| City | HOUMA |
| State | LA |
| Zip Code | 70360-4050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124011879 | Nicole Lee Kerley-mcguire | Pediatrics | 1014 W Tunnel Blvd, Houma, LA 70360-4050 | 2005-08-29 |
| 1659801694 | Leigh Griffin | Dentist | 1014 W Tunnel Blvd, Houma, LA 70360-4050 | 2017-06-13 |
| 1700323540 | Richard Bergeron II | Nurse Practitioner | 1014 W Tunnel Blvd, Houma, LA 70360-4050 | 2017-01-31 |
| 1235512666 | Beau James Leonard | Registered Nurse | 1014 W Tunnel Blvd, Houma, LA 70360 | 2015-07-02 |
| 1528492824 | Marquis D Heath | Dentist | 1014 W Tunnel Blvd, Houma, LA 70360-4050 | 2013-08-22 |
| 1437464906 | Jennifer Regina Millet | Registered Nurse | 1014 W Tunnel Blvd, Houma, LA 70360-4050 | 2010-08-09 |
| 1679726459 | Teche Action Board Inc | Pharmacy | 1014 W Tunnel Blvd, Houma, LA 70360-4050 | 2008-10-24 |
| 1275729667 | Gregory Walter Greenwood | Dentist | 1014 W Tunnel Blvd, Houma, LA 70360-4050 | 2007-09-19 |
| 1871694331 | David P Desonier | Dentist | 1014 W Tunnel Blvd, Houma, LA 70360-4050 | 2006-09-26 |
| 1114027299 | Ronald C Marts | Internal Medicine | 1014 W Tunnel Blvd, Houma, LA 70360-4050 | 2006-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382697 | Start Corporation | Clinic/Center | 106 School Street, Houma, LA 70360 | 2020-09-24 |
| 1013474196 | Christi Thibodeaux Rodrigue | Case Manager/Care Coordinator | 427west Tunnel Blvd, Houma, LA 70360 | 2019-02-26 |
| 1053801415 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1420 Saint Charles St, Houma, LA 70360 | 2018-05-11 |
| 1447780044 | Shakira Harding | Counselor | 148 Columbus Street, Houma, LA 70360 | 2017-06-15 |
| 1639608995 | Rakitha Monique Volter-jones | Counselor | 6522 West Main Street, Houma, LA 70360 | 2017-06-08 |
| 1588103469 | Eyecare Specialties | Ophthalmology | 564 Valhi Blvd, Houma, LA 70360 | 2017-02-13 |
| 1538605464 | Houma Dental Associates, LLC | Dentist | 5934 West Main St, Houma, LA 70360 | 2017-01-17 |
| 1649721143 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 143 War Horse Place, Houma, LA 70360 | 2016-10-19 |
| 1528417045 | Mandi Gaubert Bonvillain | Psychologist | 1018 Verrett Street, Houma, LA 70360 | 2016-06-06 |
| 1295182434 | Kerry M Guidry | Chiropractor | 6902 West Main Street, Houma, LA 70360 | 2016-05-18 |
| Find all providers in zip 70360 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790162626 | Amanda Eymard | Nurse Practitioner | 5599 La-311, Houma, LA 70360 | 2015-04-29 |
| 1376861278 | Helena L Richard | Nurse Practitioner | 307 Jefferson Dr, Houma, LA 70360-6115 | 2010-05-17 |
| 1144877978 | Harry Brown Jr. | Nurse Practitioner | 235 Civic Center Blvd, Houma, LA 70360-5937 | 2019-08-26 |
| 1710400833 | Brealon Michael Lirette | Nurse Practitioner | 5599 Highway 311, Houma, LA 70360-2866 | 2017-07-20 |
| 1700323540 | Richard Bergeron II | Nurse Practitioner | 1014 W Tunnel Blvd, Houma, LA 70360-4050 | 2017-01-31 |
| 1992154900 | Robbin Mulina | Nurse Practitioner | 521 Legion Ave, Houma, LA 70364-3339 | 2016-06-09 |
| 1518252337 | Beneficence Psychiatric and Mental Health Services, LLC | Nurse Practitioner | 307 Jefferson Dr, Houma, LA 70360-6115 | 2011-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972113124 | Rebirth Mental Health Services LLC | Nurse Practitioner | 2116 Gause Blvd W Ste E, Slidell, LA 70460-4120 | 2020-08-03 |
| 1427668748 | Julie Susann Dyrek | Nurse Practitioner | 1 Lakeshore Dr Ste 1830, Lake Charles, LA 70629-0114 | 2020-08-01 |
| 1376169979 | Nancy Ariwodo | Nurse Practitioner | 225 Rue La France, Lafayette, LA 70508-1565 | 2020-06-19 |
| 1578183208 | Donald Glyn Gardner II | Nurse Practitioner | 324 Blue Fox Cir, Haughton, LA 71037-7707 | 2020-04-22 |
| 1629604129 | Raelyn Marie Plauche | Nurse Practitioner | 1951 Florida Ave Sw Ste D&e, Denham Springs, LA 70726-4947 | 2020-03-16 |
| 1962035964 | Tyler Trenton Wansley | Nurse Practitioner | 23515 Us-190, Mandeville, LA 70448 | 2020-02-18 |
| 1114558715 | Danielle J Threatts Aprn LLC | Nurse Practitioner | 208 W Gloria Switch Rd Ste 219, Lafayette, LA 70507-3409 | 2020-02-01 |
| 1992359848 | Harold G Frizzell Psychiatric Services LLC | Nurse Practitioner | 300 Thompson Loop, Lafayette, LA 70506-2820 | 2019-07-29 |
| 1598227779 | Candyce Brown | Nurse Practitioner | 333 Dr Michael Debakey Dr Ste 220, Lake Charles, LA 70601-5888 | 2019-04-04 |
| 1659835346 | Cassandra Thomas-jingles Psychiatric Nurse Practitioner, LLC. | Nurse Practitioner | 156 Mcgehee Dr, Baton Rouge, LA 70815-5012 | 2019-01-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.