Shawntel Marie Moore (NPI# 1053652644, PAC ID# 0648577718) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1053652644 |
| PAC ID by PECOS | 0648577718 |
| Professional Enrollment ID | I20160502000673 |
| Full Name | Shawntel Marie Moore |
| Organization Legal Name | PEDIATRIC GROUP OF ACADIANA, LLC |
| Address |
401 Youngsville Hwy Suite 100 Lafayette LA 70508-5173 |
| Phone Number | 3373300031 |
| Gender | F |
| Graduation Year | 2012 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2466476023 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190034 | ABBEVILLE GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 401 Youngsville Hwy, Suite 100, Lafayette, LA 70508-5173 | 3373300031 | PEDIATRIC GROUP OF ACADIANA, LLC |
| Organization Legal Name | PEDIATRIC GROUP OF ACADIANA, LLC |
| Physicians | 16 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kaelyn Michelle Hebert | Nurse Practitioner | Pediatric Group of Acadiana, LLC | 520 N Lewis St, Suite 202, New Iberia, LA 70563-2094 |
| Srinivasa Yerasi | Pediatric Medicine | Pediatric Group of Acadiana, LLC | 555 Lakes Blvd, Breaux Bridge, LA 70517-3240 |
| Alison T Cantrall | Nurse Practitioner | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 200b, Lafayette, LA 70508-5173 |
| Jamie B St. Romain | Nurse Practitioner | Pediatric Group of Acadiana, LLC | 520 N Lewis St, Suite 202, New Iberia, LA 70563-2094 |
| Jibran E Atwi | Pediatric Medicine | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 100, Lafayette, LA 70508-5173 |
| Durga P Naidu | Pediatric Medicine | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 100, Lafayette, LA 70508-5173 |
| Courtney Vice Habetz | Physician Assistant | Pediatric Group of Acadiana, LLC | 520 N Lewis St, Suite 202, New Iberia, LA 70563-2094 |
| Sai Sudhakar Chennamsetty | Internal Medicine | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 100, Lafayette, LA 70508-5173 |
| Suguna Veeramachineni | Internal Medicine | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 200b, Lafayette, LA 70508-5173 |
| Cynthia M Beverly | Nurse Practitioner | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 100, Lafayette, LA 70508-5173 |
| Street Address |
401 YOUNGSVILLE HWY SUITE 100 |
| City | LAFAYETTE |
| State | LA |
| Zip | 70508-5173 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alison T Cantrall | Nurse Practitioner | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 200b, Lafayette, LA 70508-5173 |
| Jibran E Atwi | Pediatric Medicine | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 100, Lafayette, LA 70508-5173 |
| Durga P Naidu | Pediatric Medicine | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 100, Lafayette, LA 70508-5173 |
| Sai Sudhakar Chennamsetty | Internal Medicine | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 100, Lafayette, LA 70508-5173 |
| Suguna Veeramachineni | Internal Medicine | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 200b, Lafayette, LA 70508-5173 |
| Cynthia M Beverly | Nurse Practitioner | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 100, Lafayette, LA 70508-5173 |
| Himani Reddy Manthena | Internal Medicine | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 200b, Lafayette, LA 70508-5173 |
| Laszlo Papp | Pediatric Medicine | Pediatric Group of Acadiana, LLC | 401 Youngsville Hwy, Suite 100, Lafayette, LA 70508-5173 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jason W Prevost | Chiropractic | 2111 W Pinhook Rd A, Integrated Health, Lafayette, LA 70508-1504 | |
| Kimberly V Hull | Nurse Practitioner | Lhc Physician Services, LLC | 901 Hugh Wallis Rd S, Lafayette, LA 70508-2511 |
| Roseanna Laporte | Nurse Practitioner | Lhc Physician Services, LLC | 901 Hugh Wallis Rd S, Lafayette, LA 70508-2511 |
| Mia H Rabalais | Nurse Practitioner | Lhc Physician Services, LLC | 901 Hugh Wallis Rd S, Lafayette, LA 70508-2511 |
| Simone L Babineaux | Nurse Practitioner | Lhc Physician Services, LLC | 901 Hugh Wallis Rd S, Lafayette, LA 70508-2511 |
| Jayson A Thornhill | Nurse Practitioner | Lhc Physician Services, LLC | 901 Hugh Wallis Rd S, Lafayette, LA 70508-2511 |
| Casey A Robinson | Clinical Social Worker | 200 La Rue France, Suite 101, Lafayette, LA 70508-3104 | |
| Rachel Lacy Broussard | Clinical Social Worker | 200 La Rue France, Lafayette, LA 70508-3104 | |
| Joshua G Bailey | Chiropractic | Pinhook Chiropractic Clinic LLC | 100 La Rue France, Lafayette, LA 70508-3112 |
| Brad A Grizzaffi | Chiropractic | Pinhook Chiropractic Clinic LLC | 100 La Rue France, Lafayette, LA 70508-3112 |
| Find all physicians in zip 70508 | |||
| City | LAFAYETTE |
| Zip Code | 70508 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LAFAYETTE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Shawntel Marie Moore.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.