Active NPI
Sidney Champagne, RPH
- Pharmacist
- New Iberia, LA
National Provider Identifier
1053712760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11566
- Practice address
- 106 Candleglow Dr
New Iberia, LA 70563-0912 - Phone
- (337) 560-1096
- NPI assigned
- Sep 12, 2014
- Last updated
- Sep 12, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11566 | LA | Primary |
Addresses
Primary practice location
106 Candleglow Dr
New Iberia, LA 70563-0912
Mailing address
900 E Admiral Doyle Dr
New Iberia, LA 70560-6709
Phone (337) 367-2291
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)
- Not enrolled
- Credentials
- Registered Pharmacist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410480000000",
"number": "1053712760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 E ADMIRAL DOYLE DR",
"city": "NEW IBERIA",
"state": "LA",
"postal_code": "705606709",
"telephone_number": "337-367-2291",
"fax_number": "337-365-0162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 CANDLEGLOW DR",
"city": "NEW IBERIA",
"state": "LA",
"postal_code": "705630912",
"telephone_number": "337-560-1096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPAGNE",
"first_name": "SIDNEY",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-12",
"last_updated": "2014-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "11566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Iberia, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.