PEDIATRIC GROUP OF ACADIANA, LLC (NPI# 1588138903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588138903 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC GROUP OF ACADIANA, LLC |
| Practice Address |
12713 Water Way Maurepas LA 70449-1200 |
| Mailing Address |
401 Youngsville Hwy Ste 100 Lafayette LA 70508-5173 |
| Practice Telephone | 2256980211 |
| Mailing Telephone | 3373308336 |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-01-18 |
| Authorized Official Name | ALEC MOYER (BUSINESS MANAGER) |
| Authorized Official Telephone | 3373308336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Waterway Pediatrics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922619238 | Pediatric Group of Acadiana, LLC | Clinic/Center | 818 W. Veterans Memorial, Kaplan, LA 70548 | 2020-08-11 |
| 1679126510 | Pediatric Group of Acadiana, LLC | Clinic/Center | 1307 Crowley Rayne Hwy Ste C, Crowley, LA 70526-8210 | 2019-07-19 |
| 1255941829 | Pediatric Group of Acadiana, LLC | Clinic/Center | 555 Lakes Blvd, Breaux Bridge, LA 70517-3240 | 2020-08-07 |
| 1477027894 | Pediatric Group of Acadiana, LLC | Clinic/Center | 120 N Carolina St, New Roads, LA 70760-3604 | 2019-01-18 |
| 1922283225 | Pediatric Group of Acadiana, LLC | Specialist | 1119 N Main St, Saint Martinville, LA 70582-3513 | 2008-01-04 |
| 1487839783 | Pediatric Group of Acadiana, LLC | Specialist | 520 N Lewis St, Suite 202, New Iberia, LA 70563-2094 | 2008-01-04 |
| 1265499628 | Pediatric Group of Acadiana, LLC | Specialist | 401 Youngsville Hwy, Suite 100, Lafayette, LA 70508-5173 | 2006-04-28 |
| Street Address |
12713 WATER WAY |
| City | MAUREPAS |
| State | LA |
| Zip Code | 70449-1200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700261294 | Timothy Joel Stern | Nurse Practitioner | 18740 Highway 22, Maurepas, LA 70449 | 2015-07-25 |
| 1740437037 | Chris Pharmacy and Gifts LLC | Pharmacy | 18525 Highway 22, Maurepas, LA 70449-3015 | 2008-08-19 |
| 1255985347 | Trent Gordon | Pharmacist | 18525 Highway 22, Maurepas, LA 70449-3015 | 2019-07-28 |
| 1548768906 | Chelsea Rogers Miguez | Pharmacist | 18525 Highway 22, Maurepas, LA 70449-3015 | 2018-01-31 |
| 1740788256 | Cody Guitreau | Pharmacy | 18525 Highway 22, Maurepas, LA 70449-3015 | 2018-01-30 |
| 1437657046 | Marie Landry | Pharmacist | 18525 Highway 22, Maurepas, LA 70449-3015 | 2018-01-29 |
| 1134152630 | Our Lady of The Lake Physician Group, LLC | Clinic/Center | 18740 Highway 22, Maurepas, LA 70449-3018 | 2006-07-08 |
| 1356755565 | Trina M Keller | Nurse Practitioner | 18740 Highway 22, Maurepas, LA 70449-3018 | 2014-06-16 |
| 1710927330 | Linx Physical Therapy & Wellness | Physical Therapist | 12505 Homeport Dr, Suite A, Maurepas, LA 70449-3045 | 2006-06-08 |
| 1093757775 | Marcy L Linxwiler | Physical Therapist | 12505 Homeport Dr, Suite A, Maurepas, LA 70449-3045 | 2006-06-10 |
| Find all providers in zip 70449 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1356942155 | Clhg-ville Platte LLC | Clinic/Center | 804 E. Main Street, Ville Platte, LA 70586 | 2020-11-06 |
| 1568062446 | Lhcg Clxix, LLC | Clinic/Center | 821 N Union St, Opelousas, LA 70570-6313 | 2020-10-29 |
| 1760089791 | Blanchard Medical | Clinic/Center | 5948 N Market St, Shreveport, LA 71107-2017 | 2020-10-02 |
| 1922619238 | Pediatric Group of Acadiana, LLC | Clinic/Center | 818 W. Veterans Memorial, Kaplan, LA 70548 | 2020-08-11 |
| 1720606478 | Dr Lawanda Lamar Bellamy Md A Professional Medical Corporation | Clinic/Center | 1307 Crowley-rayne Hwy, Suite B, Crowley, LA 70526 | 2020-07-09 |
| 1669002002 | Franklin Parish Hospital Service Dist 1 | Clinic/Center | 7645 Gilbert Street, Gilbert, LA 71336 | 2020-01-24 |
| 1184260937 | Children's International, LLC | Clinic/Center | 5151 Plank Rd Ste 190, Baton Rouge, LA 70805-3501 | 2019-11-26 |
| 1003467440 | Clhg-acadian LLC | Clinic/Center | 151 Hill St Ste 102, Eunice, LA 70535-5845 | 2019-09-26 |
| 1164073524 | Tangi Wellness & Health | Clinic/Center | 906 C M Fagan Dr Ste B3, Hammond, LA 70403-6056 | 2019-09-26 |
| 1679126510 | Pediatric Group of Acadiana, LLC | Clinic/Center | 1307 Crowley Rayne Hwy Ste C, Crowley, LA 70526-8210 | 2019-07-19 |
| Find all providers with the same taxonomy | ||||
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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.