Individual provider Active NPI

Dametra Danielle Taylor, FNP

  • Family Nurse Practitioner
  • Many, LA
National Provider Identifier
1013416007
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP09786 Issued in LA
Practice address
1050 N Robinson St
Many, LA 71449-3536
Phone
(318) 256-8150
Fax
(318) 256-8136
NPI assigned
Feb 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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 AP09786 LA Primary

Addresses

Primary practice location

1050 N Robinson St
Many, LA 71449-3536

Mailing address

806 Jefferson Ter
New Iberia, LA 70560-5727
Phone (337) 365-4945

Other practice location 1

506 Shady Ln
Deridder, LA 70634-4248
Phone (337) 793-7465

Other practice location 2

567 Walker St
Merryville, LA 70653-3040
Phone (337) 825-1728

Other practice location 3

298 Nolan Trace Pkwy
Leesville, LA 71446
Phone (337) 392-0110

Other practice location 4

806 Jefferson Ter
New Iberia, LA 70560-5727
Phone (337) 365-4945

Other practice location 5

1009 Charity St
Abbeville, LA 70510-5302
Phone (337) 893-3443

Other practice location 6

317 Dernier St
Saint Martinville, LA 70582-3809
Phone (337) 342-2566

Other practice location 7

1004 Surrey St
Lafayette, LA 70501-6143
Phone (337) 456-6768

Other practice location 8

1002 12th St
Lafayette, LA 70501-6224
Phone (337) 534-0107

Other identifiers 1

IdentifierTypeStateIssuer
2479521MedicaidLA

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
I20181004002821 LA Practitioner - Nurse Practitioner 5092067876 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Outpatient Medical Center, Inc.Group PAC ID 5597651794, 10 clinicians

Practice addresses (Care Compare)

1640 Breazeale Springs St
Nachitoches, LA 71457-4278
Phone 31835720713205

908 S 10TH St
Suite B
Leesville, LA 71446-4614
Phone (318) 574-1453

Hospital & facility affiliations

  • Lagniappe Homecare Northwest Louisiana Home health agency, Natchitoches, LA, CCN 197478
  • Natchitoches Regional Medical Center Hospital, Natchitoches, LA, CCN 190007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP09786LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iberia Comprehensive Community Health Center, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Iberia Comprehensive Community Health Center,Inc. Current Accepting new patients
Iberia Comprehensive Community Health Center, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Outpatient Medical Center, Inc. Nurse Practitioner CurrentSince Mar 17, 2024 Accepting new patients
Outpatient Medical Center, Inc. Nurse Practitioner Past Accepting new patients

Locations

1009 Charity St
Abbeville, LA 70510
Phone (337) 893-3443

1002 12th St
Lafayette, LA 70501
Phone (337) 534-0107

1004 Surrey St
Lafayette, LA 70501
Phone (337) 456-6768

298 Nolan Trce
Leesville, LA 71446
Phone (337) 392-0110

908 S 10th St
#B
Leesville, LA 71446
Phone (337) 238-1274

1050 N Robinson St
Many, LA 71449
Phone (318) 256-8150

567 Walker St
Merryville, LA 70653
Phone (337) 365-4945

1640 Breazeale Springs St
Natchitoches, LA 71457
Phone (318) 352-9299

1500 Gold St
Natchitoches, LA 71457
Phone (318) 352-2369

806 Jefferson Ter
New Iberia, LA 70560
Phone (337) 365-4945

317 Dernier St
Saint Martinville, LA 70582
Phone (337) 342-2566

804 N Beech St
Tallulah, LA 71282
Phone (318) 574-1453

Interoperability endpoints

  • Direct secure messaging: dametra.taylor.1@29100.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1013416007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-365-4945",
            "fax_number": "337-376-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N ROBINSON ST",
            "city": "MANY",
            "state": "LA",
            "postal_code": "714493536",
            "telephone_number": "318-256-8150",
            "fax_number": "318-256-8136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 Shady Ln",
            "address_purpose": "LOCATION",
            "city": "Deridder",
            "state": "LA",
            "postal_code": "706344248",
            "country_code": "US",
            "telephone_number": "337-793-7465",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "567 Walker St",
            "address_purpose": "LOCATION",
            "city": "Merryville",
            "state": "LA",
            "postal_code": "706533040",
            "country_code": "US",
            "telephone_number": "337-825-1728",
            "fax_number": "337-825-1229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "298 Nolan Trace Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesville",
            "state": "LA",
            "postal_code": "71446",
            "country_code": "US",
            "telephone_number": "337-392-0110",
            "fax_number": "337-392-0111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "806 Jefferson Ter",
            "address_purpose": "LOCATION",
            "city": "New Iberia",
            "state": "LA",
            "postal_code": "705605727",
            "country_code": "US",
            "telephone_number": "337-365-4945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1009 Charity St",
            "address_purpose": "LOCATION",
            "city": "Abbeville",
            "state": "LA",
            "postal_code": "705105302",
            "country_code": "US",
            "telephone_number": "337-893-3443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "317 Dernier St",
            "address_purpose": "LOCATION",
            "city": "Saint Martinville",
            "state": "LA",
            "postal_code": "705823809",
            "country_code": "US",
            "telephone_number": "337-342-2566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1004 Surrey St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705016143",
            "country_code": "US",
            "telephone_number": "337-456-6768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1002 12th St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705016224",
            "country_code": "US",
            "telephone_number": "337-534-0107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "DAMETRA",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2479521",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Many, LA

Sources for this page

Verify at the official NPI Registry.