Individual provider Active NPI

Carl B Alldredge, M.D.

  • Otolaryngology Physician
  • Lafayette, LA
National Provider Identifier
1013986090
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
011336 Issued in LA
Practice address
225 Bendel Rd
Lafayette, LA 70503-2903
Phone
(337) 232-2330
Fax
(337) 232-1310
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 011336 LA Primary

Addresses

Primary practice location

225 Bendel Rd
Lafayette, LA 70503-2903

Mailing address

PO Box 52068
Lafayette, LA 70505-2068
Phone (337) 233-7174

Other identifiers 1

IdentifierTypeStateIssuer
1170224MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
011336LAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Ear, Nose, & Throat Specialists, Inc. Otolaryngology PastSince Jul 22, 2024 Accepting new patients

Organizations & group practices 1

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1013986090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52068",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052068",
            "telephone_number": "337-233-7174",
            "fax_number": "337-269-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BENDEL RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032903",
            "telephone_number": "337-232-2330",
            "fax_number": "337-232-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLDREDGE",
        "first_name": "CARL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "011336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1170224",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.