Active NPI
Mary J. St. Pierre, NP
- Nurse Practitioner
- Barksdale Afb, LA
National Provider Identifier
1063624716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP04153
- Practice address
- 243 Curtiss Rd
2 MDG/SGHC; Aerospace Medicine; Suite 100
Barksdale Afb, LA 71110-2425 - Phone
- (318) 456-6131
- Fax
- (318) 456-6246
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP04153 | LA | Primary |
Addresses
Primary practice location
243 Curtiss Rd
2 MDG/SGHC; Aerospace Medicine; Suite 100
Barksdale Afb, LA 71110-2425
Mailing address
FNP
2 MDG/SGHC; Aerospace Medicine; Suite 100
Barksdale Afb, LA 71110-2425
Phone (318) 456-6131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1143723 | Medicaid | LA |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP04153 | LA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ed Physicians of West Louisiana, LLC | Nurse Practitioner | Past | Accepting new patients |
| Caldwell Memorial Hospital Inc | 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.
-
- Rural Health Clinic/Center
- Columbia, LA
- NPI 1639189244
-
- Emergency Medicine Physician
- West Monroe, LA
- NPI 1255460143
Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342051200000",
"number": "1063624716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FNP",
"address_2": "2 MDG/SGHC; AEROSPACE MEDICINE; SUITE 100",
"city": "BARKSDALE AFB",
"state": "LA",
"postal_code": "711102425",
"telephone_number": "318-456-6131",
"fax_number": "318-456-6246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243 CURTISS RD",
"address_2": "2 MDG/SGHC; AEROSPACE MEDICINE; SUITE 100",
"city": "BARKSDALE AFB",
"state": "LA",
"postal_code": "711102425",
"telephone_number": "318-456-6131",
"fax_number": "318-456-6246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ST. PIERRE",
"first_name": "MARY",
"middle_name": "J.",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2012-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "LA",
"license": "AP04153",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1143723",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Barksdale Afb, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.