DERICK PETRIE (NPI# 1538559927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538559927 |
| Entity Type | Individual |
| Full Name | DERICK PETRIE |
| Credential | PA-C |
| Practice Address |
928 School St Houma LA 70360-4628 |
| Mailing Address |
1418 Louise St Thibodaux LA 70301-4259 |
| Practice Telephone | 9858511970 |
| Mailing Telephone | 9857914344 |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
200781 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
928 SCHOOL ST |
| City | HOUMA |
| State | LA |
| Zip Code | 70360-4628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265756266 | Watkins Family Medicine LLC | Family Medicine | 928 School St, Houma, LA 70360-4628 | 2010-03-19 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073610044 | Bradley Paul Chauvin | Physician Assistant | 1340 Grand Caillou Rd, Houma, LA 70363-5558 | 2006-09-20 |
| 1073626719 | Keith Michael Poche | Physician Assistant | 1750 Martin Luther King Blvd., Suite 107, Houma, LA 70360 | 2006-08-16 |
| 1649277047 | Monique B Blanchard | Physician Assistant | 327 Bayou Gardens Blvd., Houma, LA 70360 | 2005-06-30 |
| 1407237803 | Heidi Williams | Physician Assistant | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2015-06-11 |
| 1982855870 | Nathalie Boffy Jukes | Physician Assistant | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2008-10-09 |
| 1184721169 | Paul J Cummins | Physician Assistant | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-09-20 |
| 1992802987 | Christopher Powell | Physician Assistant | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-09-20 |
| 1285731455 | Michael Berthiaume | Physician Assistant | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-09-20 |
| 1104867258 | Kevin Mark Ricks | Physician Assistant | 1990 Industrial Boulevard, Houma, LA 70363-7055 | 2006-06-09 |
| 1225082894 | Laura Ramirez | Physician Assistant | 1990 Industrial Blvd, Houma, LA 70363-7055 | 2006-05-19 |
| Find all providers in HOUMA | ||||
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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.