CHILDRENS CLINIC OF ACADIANA LLC (NPI# 1679806178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679806178 |
| Entity Type | Organization |
| Organization Name | CHILDRENS CLINIC OF ACADIANA LLC |
| Other Organization Name | CHILDRENS CLINIC OF ACADIANA LLC |
| Practice Address |
850 N Pierce St Suite F Lafayette LA 70501-2848 |
| Practice Telephone | 3372373501 |
| Practice Fax Number | 3375044623 |
| Mailing Telephone | 3372373501 |
| Mailing Fax Number | 3375044623 |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2009-09-15 |
| Authorized Official Name | MS. MARY AMELIA DUNCAN (APRN, FNP, OWNER) |
| Authorized Official Telephone | 3372804287 |
| Authorized Official Credential | APRN, FNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
AP04543 | LA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Childrens Clinic of Acadiana LLC | Former Legal Business Name - Organization |
| Street Address |
850 N PIERCE ST SUITE F |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70501-2848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710975487 | James M. Mwatibo | Family Medicine | 850 N Pierce St, Suite D, Lafayette, LA 70501-2848 | 2005-10-07 |
| 1285972224 | Meredith Preis Lalonde | Occupational Therapist | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2013-01-25 |
| 1306102884 | Acadiana Wound Clinic LLC | Clinic/Center | 850 N Pierce St, Suite C, Lafayette, LA 70501-2848 | 2012-04-09 |
| 1982975785 | Jennifer Magee Domengeaux | Speech-Language Pathologist | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2012-01-25 |
| 1265703409 | Mollie Margaret Matthews | Speech-Language Pathologist | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2012-01-19 |
| 1548569668 | Amy Christine Dean | Physical Therapist | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2011-03-16 |
| 1932403003 | Benjamin Dougles Wilson | Physical Therapist | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2011-01-05 |
| 1144538455 | Carolyn Y. Smith | Physical Medicine & Rehabilitation | 850 N Pierce St, Suite C, Lafayette, LA 70501-2848 | 2010-09-21 |
| 1609184191 | K and S Therapy | Clinic/Center | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2010-09-17 |
| 1518280916 | Pride Plaza | Clinic/Center | 850 N Pierce St, Lafayette, LA 70501-2848 | 2010-03-12 |
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| 1508227968 | Vicky Marie Senegal | Home Health Aide | 304 1/2 Rubria St., Lafayette, LA 70501 | 2016-03-14 |
| 1558766931 | Corey Gerard Porche | Counselor | 708 Jefferson Blvd., Lafayette, LA 70501 | 2014-10-28 |
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| 1437408549 | Jensen J. Bergeron | Counselor | 600 Jefferson Street Suite 903, Lafayette, LA 70501 | 2012-09-05 |
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| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1609967900 | Kirtland Dana Swan | Clinic/Center | 113 Saint Thomas St Ste A, Lafayette, LA 70506-4575 | 2006-09-28 |
| 1497302871 | Boulder Community Health | Clinic/Center | 1000 W South Boulder Rd Ste 110, Lafayette, CO 80026-2753 | 2019-08-21 |
| 1336611201 | Wellness for Life | Clinic/Center | 2529 Schuyler Ave, Lafayette, IN 47905-3979 | 2018-12-17 |
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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.