NPIMap

Individual provider Active NPI

Craig W Manzer, NP

  • Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1013114164
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP05317 Issued in LA
Practice address
4630 Ambassador Caffery Pkwy Ste 302
Lafayette, LA 70508-6950
Phone
(337) 470-3580
Fax
(337) 470-3586
NPI assigned
Jul 2, 2007
Last updated
May 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP05317 LA Primary

Addresses

Primary practice location

4630 Ambassador Caffery Pkwy Ste 302
Lafayette, LA 70508-6950

Mailing address

3311 Prescott Rd Ste 312
Alexandria, LA 71301-3984
Phone (318) 528-1998

Other practice location 1

3311 Prescott Rd Ste 312
Alexandria, LA 71301-3984
Phone (318) 528-1998

Other identifiers 1

IdentifierTypeStateIssuer
1348406MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080626000256 LA Practitioner - Nurse Practitioner 9032281647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lourdes Physician Group LLCGroup PAC ID 7214177757, 157 clinicians

Practice addresses (Care Compare)

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2990

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Cardiovascular & Thoracic Institute, LLC CurrentSince Oct 18, 2007 Accepting new patients
Lourdes Physician Group LLC Nurse Practitioner CurrentSince Jun 7, 2021 Accepting new patients

Locations

3311 Prescott Rd
Ste 202
Alexandria, LA 71301
Phone (318) 442-0106

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

1103 Kaliste Saloom Rd
Ste 200
Lafayette, LA 70508
Phone (337) 470-3580

4630 Ambassador Caffery Pkwy
Ste 302
Lafayette, LA 70508
Phone (337) 470-3580

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

Organizations & group practices 2

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

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1013114164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 PRESCOTT RD STE 312",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013984",
            "telephone_number": "318-528-1998",
            "fax_number": "318-767-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 AMBASSADOR CAFFERY PKWY STE 302",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086950",
            "telephone_number": "337-470-3580",
            "fax_number": "337-470-3586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3311 Prescott Rd Ste 312",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713013984",
            "country_code": "US",
            "telephone_number": "318-528-1998",
            "fax_number": "318-767-9931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANZER",
        "first_name": "CRAIG",
        "middle_name": "W",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP05317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1348406",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.