Individual provider Active NPI

Anne Fradella Favret, NP-C

  • Family Nurse Practitioner
  • Metairie, LA
National Provider Identifier
1083673164
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN071553 AP04841 Issued in LA
Practice address
4200 Houma Blvd
1St Floor
Metairie, LA 70006
Phone
(504) 456-9199
Fax
(504) 891-0082
NPI assigned
Mar 18, 2006
Last updated
Feb 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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 RN071553 AP04841 LA Primary

Addresses

Primary practice location

4200 Houma Blvd
1St Floor
Metairie, LA 70006

Mailing address

4200 Houma Blvd
1St Floor
Metairie, LA 70006
Phone (504) 834-8232

Other identifiers 1

IdentifierTypeStateIssuer
1527190MedicaidLA

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
I20051005000481 LA Practitioner - Nurse Practitioner 9830124155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1415 Tulane Ave
New Orleans, LA 70112-2600
Phone (504) 988-5800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN071553 AP04841LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Sep 1, 2020 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Sep 1, 2020 Accepting new patients
Tchefuncte Cardiovascular Associates Past Accepting new patients

Locations

3017 Galleria Dr
Metairie, LA 70001
Phone (504) 830-2454

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

4200 Houma Blvd
Fl 1
Metairie, LA 70006
Phone (504) 454-5520

4200 Houma Blvd
Fl 5
Metairie, LA 70006
Phone (504) 576-1219

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1430 Tulane Ave
#T
New Orleans, LA 70112

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1083673164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "address_2": "1ST FLOOR",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70006",
            "telephone_number": "504-834-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "address_2": "1ST FLOOR",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70006",
            "telephone_number": "504-456-9199",
            "fax_number": "504-891-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVRET",
        "first_name": "ANNE",
        "middle_name": "FRADELLA",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-18",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN071553 AP04841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527190",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.