Active NPI
Kenneth Wayne Eaglin Jr.
- Case Manager/Care Coordinator
- Lafayette, LA
National Provider Identifier
1053889261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1017 Saint John St
Lafayette, LA 70501 - Phone
- (337) 261-2300
- Fax
- (337) 261-9080
- NPI assigned
- Nov 6, 2018
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1017 Saint John St
Lafayette, LA 70501
Mailing address
1301 Youree Dr
Shreveport, LA 71101-5117
Phone (318) 675-0804
Other practice location 1
108 Spanish Pl
Lafayette, LA 70507-2052
Phone (337) 371-7170
Other practice location 2
108 Spanish Pl
Lafayette, LA 70507-2052
Phone (337) 371-7170
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitation Services of Northwest Louisiana, LLC | Past | Accepting new patients | |
| Hco Behavioral Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Greenwell Springs, LA
- NPI 1962884726
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Shreveport, LA
- NPI 1427137074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547424000000",
"number": "1053889261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 YOUREE DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711015117",
"telephone_number": "318-675-0804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 SAINT JOHN ST",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "70501",
"telephone_number": "337-261-2300",
"fax_number": "337-261-9080"
}
],
"practiceLocations": [
{
"address_1": "108 Spanish Pl",
"address_purpose": "LOCATION",
"city": "Lafayette",
"state": "LA",
"postal_code": "705072052",
"country_code": "US",
"telephone_number": "337-371-7170",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "108 Spanish Pl",
"address_purpose": "LOCATION",
"city": "Lafayette",
"state": "LA",
"postal_code": "705072052",
"country_code": "US",
"telephone_number": "337-371-7170",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EAGLIN",
"first_name": "KENNETH",
"middle_name": "WAYNE",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-06",
"last_updated": "2019-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.