Individual provider Active NPI

Teddi Poche' Willis, APRN, FNP

  • Family Nurse Practitioner
  • Abbeville, LA
National Provider Identifier
1033292248
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APO3138 Issued in LA
Practice address
2305 Richard St
Abbeville, LA 70510-3223
Phone
(337) 892-9800
NPI assigned
Oct 23, 2006
Last updated
Jun 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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 APO3138 LA Primary

Addresses

Primary practice location

2305 Richard St
Abbeville, LA 70510-3223

Mailing address

109 Turfway Dr
Lafayette, LA 70508-5609
Phone (337) 371-0362

Other identifiers 1

IdentifierTypeStateIssuer
1140074MedicaidLA

Other names 1

  • Teddi Perret Former name

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
I20050707000494 LA Practitioner - Nurse Practitioner 5294771663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lourdes After Hours LLCGroup PAC ID 5496704553, 29 clinicians

Practice addresses (Care Compare)

1821 Rees St
Breaux Bridge, LA 70517-4209
Phone (337) 442-6959

2932 Ambassador Caffery Pkwy
Suite a
Lafayette, LA 70506-6756
Phone (337) 294-0900

3824 NE Evangeline Thruway
Carencro, LA 70520-5966
Phone (337) 565-2675

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APO3138LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CLHG-Ville Platte LLC CurrentSince Jul 20, 2016 Accepting new patients
Lourdes After Hours LLC CurrentSince Feb 3, 2016 Accepting new patients
Lourdes After Hours LLC CurrentSince Feb 3, 2016 Accepting new patients
Scott Family Clinic PastSince Jul 29, 2012 Accepting new patients

Locations

3824 NE Evangeline Thruway
Carencro, LA 70520
Phone (337) 565-2675

1700 Kaliste Saloom Rd
Ste 200
Lafayette, LA 70508
Phone (337) 981-5085

536 Veterans Blvd
Washington, LA 70589
Phone (337) 628-5014

Interoperability endpoints

  • Direct secure messaging: twillis5278224@direct.casso.us.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1033292248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 TURFWAY DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085609",
            "telephone_number": "337-371-0362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 RICHARD ST",
            "city": "ABBEVILLE",
            "state": "LA",
            "postal_code": "705103223",
            "telephone_number": "337-892-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "TEDDI POCHE'",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "APO3138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1140074",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TEDDI",
            "last_name": "PERRET",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Abbeville, LA

Sources for this page

Verify at the official NPI Registry.