MR. SENIA TIMOTHY FONTENOT (NPI# 1861783417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861783417 |
| Entity Type | Individual |
| Full Name | MR. SENIA TIMOTHY FONTENOT |
| Credential | ANP-C |
| Practice Address |
1747 Imperial Blvd Lake Charles LA 70605-5362 |
| Mailing Address |
501 Doctor Michael Debakey Dr Lake Charles LA 70601-5724 |
| Practice Telephone | 3377217236 |
| Practice Fax Number | 3377217237 |
| Mailing Telephone | 3373128258 |
| Mailing Fax Number | 3373126711 |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2017-03-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WX0800X |
Registered Nurse Specialization: Orthopedic |
RN117238 | LA | Nursing Service Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP06594 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2171381 | 05 |
| Street Address |
1747 IMPERIAL BLVD |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70605-5362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487649091 | Staci Simon Boudreaux | Physician Assistant | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2005-09-20 |
| 1376168971 | Cody Gaupel | Student in an Organized Health Care Education/Training Program | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2020-06-10 |
| 1538703335 | Center for Orthopaedics and Spine LLC | Family Medicine | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2019-11-05 |
| 1013579150 | Bradley Lane Jimerson | Student in an Organized Health Care Education/Training Program | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2019-06-28 |
| 1912560541 | Haley Cook Cart | Physician Assistant | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2019-04-18 |
| 1174014534 | Susan Helms Cart | Occupational Therapist | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2018-05-22 |
| 1679071161 | Ashley A Nix | Registered Nurse | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2018-01-30 |
| 1235584004 | Matthew Mccabe | Podiatrist | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2016-04-29 |
| 1295100808 | Lauren Ashley Sexton | Specialist/Technologist | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2015-12-08 |
| 1326422924 | Lance Henagan | Nurse Practitioner | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2015-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283606 | Kristin R Morris | Clinical Nurse Specialist | 1900 W. Gaythier Rd, Lake Charles, LA 70605 | 2020-10-21 |
| 1548871577 | Jacob M Theriot | Nurse Practitioner | 2640 County Club Rd., Lake Charles, LA 70605 | 2020-08-13 |
| 1053898403 | Heather Spallino Duplechain | Nurse Practitioner | 6713 Nelson Rd., Lake Charles, LA 70605 | 2018-07-27 |
| 1578057956 | Noor Deeb Weckerly | Nurse Practitioner | 6713 Nelson Rd, Lake Charles, LA 70605 | 2018-06-19 |
| 1861993354 | Therapy Works of Swla LLC | Physical Therapist | 4750 Lake Street, Lake Charles, LA 70605 | 2018-02-21 |
| 1669998852 | Amd Healthcare Lc, LLC | General Acute Care Hospital | 3730 Nelson Road, Lake Charles, LA 70605 | 2017-08-18 |
| 1619422474 | Kaitlyn Pinkerton | Specialist/Technologist | 800 E Mcneese St, Lake Charles, LA 70605 | 2016-08-22 |
| 1104274679 | Kelly Rogers | Counselor | 90 N. Luke 102l, Lafayette, LA 70605 | 2016-05-25 |
| 1548616220 | Lisa Monticello Snider | Neurological Surgery | 3297 Portrush Drive, Lake Charles, LA 70605 | 2016-05-11 |
| 1114387404 | Louisiana Dental Professionals, Donovan Dronet, Dds, A Professional De | Dentist | 4459 Nelson Rd, Suite 120, Lake Charles, LA 70605 | 2016-02-29 |
| Find all providers in zip 70605 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154747186 | Dennis W. Kleinpeter | Nurse Practitioner | 503 W Sallier St, Lake Charles, LA 70601-5756 | 2014-03-14 |
| 1629377239 | Hinton Np Services, LLC | Nurse Practitioner | 2822 Henderson Forest Dr, Lake Charles, LA 70605-2259 | 2011-03-22 |
| 1437390721 | Dawn Marie Hinton | Nurse Practitioner | 4150 Nelson Rd Ste A3, Lake Charles, LA 70605-4169 | 2009-03-16 |
| 1689774259 | Mary Jane Mckinnie | Nurse Practitioner | 905 11th St, Lake Charles, LA 70601-6230 | 2006-09-24 |
| 1164403630 | Anna Marie Crawford | Nurse Practitioner | 555 S Ryan St, 101, Lake Charles, LA 70601-5724 | 2005-11-10 |
| 1235492778 | Jennifer Taylor Graham | Nurse Practitioner | 2770 3rd Ave # S350, Lake Charles, LA 70601-8994 | 2012-06-20 |
| 1962763714 | Morgan Rae Gilmore | Nurse Practitioner | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2012-06-07 |
| 1174800569 | Hollie Steffens Donnelly | Nurse Practitioner | 2802 Pineview St, Lake Charles, LA 70615-2063 | 2011-11-14 |
| 1083994347 | Carolyn Rideaux | Nurse Practitioner | 2837 Ernest St, Lake Charles, LA 70601-8785 | 2011-08-18 |
| 1275811572 | Karie J Savoy | Nurse Practitioner | 2770 3rd Ave Ste 350, Lake Charles, LA 70601-0404 | 2011-08-03 |
| Find all providers in LAKE CHARLES | ||||
| City | LAKE CHARLES |
| Zip Code | 70605 |
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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.