Individual provider Active NPI

Robert P. St. Amant, M.D.

  • Family Medicine Physician
  • Gonzales, LA
National Provider Identifier
1104822774
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
013278 Issued in LA
Practice address
2647 S Saint Elizabeth Blvd Ste 311
Gonzales, LA 70737-5020
Phone
(225) 743-2833
Fax
(225) 743-2074
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 013278 LA Primary

Addresses

Primary practice location

2647 S Saint Elizabeth Blvd Ste 311
Gonzales, LA 70737-5020

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 765-5727

Other identifiers 2

IdentifierTypeStateIssuer
1183318MedicaidLA
080148367OtherLARAILROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rstamant15134@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110103000548 LA Practitioner - Family Practice 6608064837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
013278LAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1104822774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-5727",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 S SAINT ELIZABETH BLVD STE 311",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707375020",
            "telephone_number": "225-743-2833",
            "fax_number": "225-743-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. AMANT",
        "first_name": "ROBERT",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "013278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1183318",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080148367",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rstamant15134@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rstamant15134@direct.casso.us.com",
            "address_1": "2647 S Saint Elizabeth Blvd Ste 311",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707375020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2647 S Saint Elizabeth Blvd Ste 311",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707375020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

Verify at the official NPI Registry.