MR. MARC THOMAS HEBERT (NPI# 1932123221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932123221 |
| Entity Type | Individual |
| Full Name | MR. MARC THOMAS HEBERT |
| Credential | PA |
| Practice Address |
1747 Imperial Blvd Lake Charles LA 70605-5362 |
| Practice Telephone | 3377217236 |
| Mailing Telephone | 3377217236 |
| Mailing Fax Number | 3377217237 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-09-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA200015 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1812994 | 05 | |
| LA | MEDICARE LEGACY NUMBER | 5D847P624 | 01 |
| 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 |
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| 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 | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184846792 | Donna Louise Bourque | Physician Assistant | 801 W Bayou Pines Dr, Lake Charles, LA 70601-7076 | 2007-05-03 |
| 1558301416 | Brenda G Holcomb | Physician Assistant | 1717 Oak Park Blvd, Second Floor, Lake Charles, LA 70601-8991 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104423151 | Osler Surgical Services LLC | Physician Assistant | 929 Tezcucco Ct, Covington, LA 70433-8157 | 2020-10-02 |
| 1841841855 | Kasie Danielle Nelson | Physician Assistant | 8585 Picardy Ave Ste 514, Baton Rouge, LA 70809-3748 | 2019-09-23 |
| 1013575018 | Louisiana Surgical Assist, L.L.C. | Physician Assistant | 1374 Knollwood Dr, Baton Rouge, LA 70808-8647 | 2019-06-04 |
| 1285290098 | Nicole Michelle Toups | Physician Assistant | 2551 Greenwood Rd Ste 311, Shreveport, LA 71103-3981 | 2019-05-16 |
| 1437712114 | Karley Marie Boagni | Physician Assistant | 3434 Prytania St Ste 410, New Orleans, LA 70115-3574 | 2019-04-17 |
| 1144793175 | Picardy Surgical Assist II, L.L.C. | Physician Assistant | 7425 Bocage Blvd, Baton Rouge, LA 70809-1141 | 2019-01-02 |
| 1952874984 | Perkins Surgical Assist II, L.L.C. | Physician Assistant | 18611 Saint Andrews Ct W, Prairieville, LA 70769-3251 | 2019-01-02 |
| 1578033825 | Picardy Surgical Assist, L.L.C. | Physician Assistant | 7301 Hennessy Blvd Ste 300, Baton Rouge, LA 70808-4794 | 2018-11-29 |
| 1609362177 | Harley Ann Augustine | Physician Assistant | 3001 Division St, Metairie, LA 70002-5854 | 2018-07-07 |
| 1750880134 | Robert Gomann Genovese II | Physician Assistant | 1233 Wayne Gilmore Cir Ste 250a, Opelousas, LA 70570-6405 | 2018-02-12 |
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| 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.