Individual provider Active NPI

Nicholas S Fuglaar, FNP-C

  • Family Nurse Practitioner
  • Thibodaux, LA
National Provider Identifier
1043854086
Registry record updated Jan 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
210931 Issued in LA
Practice address
2031 Audubon Ave
Thibodaux, LA 70301-5073
Phone
(985) 803-8383
NPI assigned
Nov 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2020

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 210931 LA Primary

Addresses

Primary practice location

2031 Audubon Ave
Thibodaux, LA 70301-5073

Mailing address

2031 Audubon Ave
Thibodaux, LA 70301-5073
Phone (985) 803-8383

Other practice location 1

1411 Saint Charles St
Houma, LA 70360-3964
Phone (985) 709-0136

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
I20200128000314 LA Practitioner - Nurse Practitioner 5890120562 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
210931LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Louisiana Medical Associates CurrentSince Apr 14, 2020 Accepting new patients
BHG Lxii LLC CurrentSince Jun 26, 2023 Accepting new patients
BHG Lxii LLC Nurse Practitioner CurrentSince Jun 26, 2023 Accepting new patients
South Louisiana Medical Associates Family Current Accepting new patients
South Louisiana Medical Associates Nurse Practitioner CurrentSince Apr 14, 2020 Accepting new patients
BHG Lxii LLC Current Accepting new patients
St Mary Emergency Group LLC Nurse Practitioner CurrentSince Aug 1, 2021 Accepting new patients
Coastal Urgent Care, LLC CurrentSince Jan 11, 2020 Accepting new patients

Locations

9808 Bluebonnet Blvd
Baton Rouge, LA 70810
Phone (225) 224-8121

2762 Continental Dr
Ste 201
Baton Rouge, LA 70808

1124 S Burnside Ave
Ste 100A
Gonzales, LA 70737
Phone (225) 644-5503

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

1125 Marguerite St
Morgan City, LA 70380
Phone (985) 380-4434

2235 Poydras St
Unit B
New Orleans, LA 70119
Phone (504) 524-7205

1303 Line Ave
Ste 600
Shreveport, LA 71101
Phone (318) 425-3400

5001 Spring Vly
Ste 600E
Dallas, TX 75244

Interoperability endpoints

  • Direct secure messaging: nicholas.fuglaar.p2@direct.alegiscare.nextgenshare.com
  • Direct secure messaging: nicholas.fuglaar.p1@direct.alegiscare.nextgenshare.com

Organizations & group practices 8

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": "1572652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578700800000",
    "number": "1043854086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 AUDUBON AVE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015073",
            "telephone_number": "985-803-8383",
            "fax_number": "985-227-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 AUDUBON AVE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015073",
            "telephone_number": "985-803-8383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 Saint Charles St",
            "address_purpose": "LOCATION",
            "city": "Houma",
            "state": "LA",
            "postal_code": "703603964",
            "country_code": "US",
            "telephone_number": "985-709-0136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUGLAAR",
        "first_name": "NICHOLAS",
        "middle_name": "S",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-02",
        "last_updated": "2020-01-11",
        "certification_date": "2020-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "210931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.