Individual provider Active NPI

Brent C Tatford, MD

  • Emergency Medicine Physician
  • Houma, LA
National Provider Identifier
1043248198
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD026042 Issued in LA
Practice address
1990 Industrial Blvd
Houma, LA 70363-7055
Phone
(985) 868-9300
Fax
(985) 851-0053
NPI assigned
Jun 29, 2006
Last updated
Sep 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD026042 LA Primary

Addresses

Primary practice location

1990 Industrial Blvd
Houma, LA 70363-7055

Mailing address

1990 Industrial Blvd
Houma, LA 70363-7055
Phone (985) 868-9300

Other identifiers 1

IdentifierTypeStateIssuer
1056332MedicaidLA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070214000279 LA Practitioner - Emergency Medicine 3577565977 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thibodaux Emergency Physicians Group LLCGroup PAC ID 2769760537, 9 clinicians

Practice addresses (Care Compare)

602 N Acadia Rd
ER Dept Thibodaux Medical Center
Thibodaux, LA 70301-4823
Phone (985) 447-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD026042LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodaux Regional Urgent Care LLC CurrentSince Oct 1, 2021 Accepting new patients
Thibodaux Emergency Physicians Group LLC Emergency Medicine CurrentSince Nov 9, 2016 Accepting new patients
South Louisiana Medical Associates CurrentSince Jul 1, 2006 Accepting new patients
Thibodaux Regional Urgent Care, LLC CurrentSince Oct 1, 2021 Accepting new patients
South Louisiana Medical Associates Emergency Medicine CurrentSince Jul 1, 2006 Accepting new patients
South Louisiana Medical Associates Past Accepting new patients

Locations

1411 Saint Charles St
Houma, LA 70360
Phone (985) 256-4065

1990 Industrial Blvd
Houma, LA 70363
Phone (985) 868-9300

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

Interoperability endpoints

  • Direct secure messaging: brent.tatford.1@25352.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25352/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1043248198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 INDUSTRIAL BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-868-9300",
            "fax_number": "985-851-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 INDUSTRIAL BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-868-9300",
            "fax_number": "985-851-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATFORD",
        "first_name": "BRENT",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD026042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1056332",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.