Organization Active NPI

Grafton Dermatology and Cosmetic Surgery

  • Specialist
  • Houma, LA
National Provider Identifier
1053400416
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
022623 Issued in LA
Legal business name
GRAFTON DERMATOLOGY AND COSMETIC SURGERY
Practice address
327 Bayou Gardens Blvd
Houma, LA 70364-1434
Phone
(985) 876-5000
Fax
(985) 876-5280
NPI assigned
Oct 12, 2006
Last updated
Feb 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Authorized official

Name
Dr. Lee Hoye Grafton, MDNPI 1700881141
Title
Ceo
Phone
(985) 876-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 023735 LA
Specialist 174400000X A10451 LA
Specialist 174400000X 022623 LA Primary

Addresses

Primary practice location

327 Bayou Gardens Blvd
Houma, LA 70364-1434

Mailing address

327 Bayou Gardens Blvd
Houma, LA 70364-1434
Phone (985) 876-5000

Other identifiers 3

IdentifierTypeStateIssuer
1441953MedicaidLA
4359897160OtherLAB;UE CROSS DR. CHARBONNET
435061414AOtherLABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041210000120 LA Part B Supplier - Clinic/Group Practice 8123085248 Receives reassigned benefits from 6 practitioners
Practice locations: Houma, LA; Morgan City, LA; Raceland, LA; Thibodaux, LA

National Provider Directory

National Provider Directory

Locations

327 Bayou Gardens Blvd
Houma, LA 70364
Phone (985) 876-5000

1216 N Victor II Blvd
Ste 200
Morgan City, LA 70380
Phone (866) 493-8899

1253 Canal Blvd
Thibodaux, LA 70301
Phone (985) 493-8899

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1053400416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 BAYOU GARDENS BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703641434",
            "telephone_number": "985-876-5000",
            "fax_number": "985-876-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 BAYOU GARDENS BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703641434",
            "telephone_number": "985-876-5000",
            "fax_number": "985-876-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAFTON DERMATOLOGY AND COSMETIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "GRAFTON",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "HOYE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "985-876-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "023735",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "A10451",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "022623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1441953",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B;UE CROSS DR. CHARBONNET",
            "identifier": "4359897160",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "435061414A",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.