NPIMap

Individual provider Active NPI

Emilie Anne Adekanbi, FNP-C

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1093462376
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
224420 Issued in LA
Practice address
1715 Wolf Cir
Lake Charles, LA 70605-2353
Phone
(337) 480-7499
Fax
(337) 480-7498
NPI assigned
Mar 7, 2022
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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 224420 LA Primary

Addresses

Primary practice location

1715 Wolf Cir
Lake Charles, LA 70605-2353

Mailing address

PO Box 122525 Dept 2525
Dallas, TX 75312-2152
Phone (337) 494-2921

Other identifiers 1

IdentifierTypeStateIssuer
AP24420OtherLASTATE NP LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220426002692 LA Practitioner - Nurse Practitioner 3971990706 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Charles Medical Services Urology LLCGroup PAC ID 4284738063, 5 clinicians

Practice addresses (Care Compare)

1715 Wolf Cir
Lake Charles, LA 70605-2353
Phone (337) 480-7499

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224420LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Charles Medical Services Urology LLC CurrentSince Mar 7, 2025 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Aug 9, 2024 Accepting new patients
Cardiovascular Specialists of Southwest Louisiana, LLC PastSince Apr 14, 2022 Accepting new patients

Locations

1715 Wolf Cir
Lake Charles, LA 70605
Phone (337) 480-7499

2770 3rd Ave
Ste 240
Lake Charles, LA 70601
Phone (337) 494-4656

201 Saint Charles Ave
Ste 2500
New Orleans, LA 70170
Phone (504) 582-1416

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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 10

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": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1093462376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122525 DEPT 2525",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122152",
            "telephone_number": "337-494-2921",
            "fax_number": "337-494-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 WOLF CIR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706052353",
            "telephone_number": "337-480-7499",
            "fax_number": "337-480-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEKANBI",
        "first_name": "EMILIE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "224420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE NP LICENSE",
            "identifier": "AP24420",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.