Individual provider Active NPI

Brandi Rene Boutte, FNP-C

  • Family Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1003371840
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
203614 Issued in LA
Practice address
220 Hebrard Blvd
Lafayette, LA 70504
Phone
(337) 482-1293
Fax
(337) 482-6428
NPI assigned
Feb 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 203614 LA Primary

Addresses

Primary practice location

220 Hebrard Blvd
Lafayette, LA 70504

Mailing address

1101 Kaliste Saloom Rd Ste 304
Lafayette, LA 70508-5705
Phone (337) 988-5646

Other identifiers 1

IdentifierTypeStateIssuer
2490681MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190408000366 LA Practitioner - Nurse Practitioner 7719228436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology and Pain Consultants LLCGroup PAC ID 3870490402, 48 clinicians

Practice addresses (Care Compare)

1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5784
Phone (337) 988-5646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology & Pain Consultants, LLC CurrentSince Feb 15, 2019 Accepting new patients
University of Louisiana at Lafayette CurrentSince Dec 21, 2025 Accepting new patients
Fleur de Lis Family Healthcare of Cankton Family Past Accepting new patients

Locations

220 Hebrard Blvd
Lafayette, LA 70503
Phone (337) 482-1293

4811 Ambassador Caffery Pkwy
Ste 100
Lafayette, LA 70508
Phone (337) 237-8119

1101 Kaliste Saloom Rd
Ste 304
Lafayette, LA 70508

1101 Kaliste Saloom Rd
Lafayette, LA 70508
Phone (337) 231-5775

1103 Kaliste Saloom Rd
Ste 304
Lafayette, LA 70508
Phone (318) 981-3546

Interoperability endpoints

  • Direct secure messaging: brandi.boutte.1@21513.direct.athenahealth.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1003371840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 KALISTE SALOOM RD STE 304",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085705",
            "telephone_number": "337-988-5646",
            "fax_number": "337-796-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HEBRARD BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70504",
            "telephone_number": "337-482-1293",
            "fax_number": "337-482-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTTE",
        "first_name": "BRANDI",
        "middle_name": "RENE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "203614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2490681",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.