PAMELA LODGE (NPI# 1710435813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710435813 |
| Entity Type | Individual |
| Full Name | PAMELA LODGE |
| Practice Address |
3645 Grenada Dr Saint Gabriel LA 70776-4645 |
| Practice Telephone | 2252268885 |
| Mailing Telephone | 2252268885 |
| Enumeration Date | 2016-09-17 |
| Last Update Date | 2019-10-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
3645 GRENADA DR |
| City | SAINT GABRIEL |
| State | LA |
| Zip Code | 70776-4645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225487101 | St Gabriel Health Clinic Inc | Clinic/Center | 5600 Monticello Dr, St Gabriel, LA 70776 | 2016-06-10 |
| 1821464587 | St Gabriel Health Clinic Inc | Clinic/Center | 5760 Monticello, St Gabriel, LA 70776 | 2015-08-18 |
| 1942575105 | Reginald Grace Sr. | Counselor | 6225 Plantation Dr., St. Gabriel, LA 70776 | 2012-03-20 |
| 1407185226 | Vonda Kay Gustin | Nurse Practitioner | 6295 Highway 74, St. Gabriel, LA 70776 | 2009-12-08 |
| 1912236738 | Cynthia Anne Park | Clinical Nurse Specialist | 6925 Highway 74, St. Gabriel, LA 70776 | 2009-12-08 |
| 1417147851 | Adolph Brooks Cronan Jr. | Family Medicine | River Road, Syngenta Corp, St Gabriel, LA 70776 | 2007-08-01 |
| 1215159272 | Pamela B. Ross | Nurse Practitioner | 7205 Hwy. 74, St. Gabriel, LA 70776 | 2007-05-02 |
| 1548310881 | George Elliott Inc | Pharmacy | 6150 Hwy 74, St Gabriel, LA 70776 | 2007-01-11 |
| 1790014512 | Johnny Francois Prejean Jr. | Internal Medicine | 6925 Highway 74, St. Gabriel, LA 70776 | 2009-12-08 |
| 1861635443 | Maureen Coughlin | Social Worker | 5760 Monticello Drive, St Gabriel, LA 70776 | 2009-04-13 |
| Find all providers in zip 70776 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194215053 | Dedrick Wolfe | Case Manager/Care Coordinator | 6610 Highway 74 Apt 407, Saint Gabriel, LA 70776-4566 | 2018-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124762 | Mary Flemon | Case Manager/Care Coordinator | 733 Keyser Ave Ste 120, Natchitoches, LA 71457-0039 | 2020-11-02 |
| 1992305023 | Deonna Hawkins Jackson | Case Manager/Care Coordinator | 17616 Heritage Estates Dr, Baton Rouge, LA 70810-6579 | 2020-10-28 |
| 1306445713 | Beverly Jean Holmes | Case Manager/Care Coordinator | 9331 Foster Rd Apt C, Baton Rouge, LA 70811-2736 | 2020-10-19 |
| 1922606326 | Christie Hitchens | Case Manager/Care Coordinator | 1041 Chariot Dr, Baton Rouge, LA 70816-1842 | 2020-10-16 |
| 1134727514 | Shatiya Reshun Williams | Case Manager/Care Coordinator | 6121 Dauphine St, New Orleans, LA 70117-2109 | 2020-10-16 |
| 1750989190 | Bridgette Lynette Azoanee | Case Manager/Care Coordinator | 4119 Lake Sherwood Ave E, Baton Rouge, LA 70816-7322 | 2020-10-16 |
| 1447858923 | Ajona Lavallais | Case Manager/Care Coordinator | 521 Redbird Dr, Alexandria, LA 71303-3934 | 2020-10-15 |
| 1629676465 | Jessica Dennis | Case Manager/Care Coordinator | 2950 Chippewa St, Baton Rouge, LA 70805-8126 | 2020-10-14 |
| 1720686769 | Wyona Jordan | Case Manager/Care Coordinator | 6980 Saint Francis Ave, Baton Rouge, LA 70811-1419 | 2020-10-13 |
| 1043817331 | Wanda Frazier | Case Manager/Care Coordinator | 203 Robert Lee Cir, Lafayette, LA 70506-3130 | 2020-10-08 |
| Find all providers with the same taxonomy | ||||
| City | SAINT GABRIEL |
| Zip Code | 70776 |
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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.