Individual provider Active NPI

Donna Marie Fox, MD

  • Pediatrics Physician
  • Lafayette, LA
National Provider Identifier
1104847128
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
019491 Issued in LA
Practice address
4650 Ambassador Caffery Pkwy Ste 204
Lafayette, LA 70508-6926
Phone
(337) 504-5200
Fax
(337) 504-5150
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 019491 LA Primary

Addresses

Primary practice location

4650 Ambassador Caffery Pkwy Ste 204
Lafayette, LA 70508-6926

Mailing address

4650 Ambassador Caffery Pkwy Ste 204
Lafayette, LA 70508-6926
Phone (337) 504-5200

Other practice location 1

4540 Ambassador Caffery Pkwy Bldg D Ste C200
Lafayette, LA 70508
Phone (337) 504-5200

Other identifiers 1

IdentifierTypeStateIssuer
1092438MedicaidLA

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
I20080514000508 LA Practitioner - Pediatric Medicine 6800965039 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019491LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Physician Group LLC CurrentSince Aug 22, 2021 Accepting new patients
George Jude Bares MD Apmc Pediatrics PastSince Mar 20, 2006 Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

4630 Ambassador Caffery Pkwy
Ste 308
Lafayette, LA 70508
Phone (337) 289-5277

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 371-3135

4650 Ambassador Caffery Pkwy
Ste 204
Lafayette, LA 70508
Phone (337) 470-5239

4540 Ambassador Caffery Pkwy
Ste C200
Lafayette, LA 70508
Phone (337) 889-5830

Interoperability endpoints

  • Direct secure messaging: dfox296537@direct.casso.us.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104847128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 AMBASSADOR CAFFERY PKWY STE 204",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086926",
            "telephone_number": "337-504-5200",
            "fax_number": "337-504-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 AMBASSADOR CAFFERY PKWY STE 204",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086926",
            "telephone_number": "337-504-5200",
            "fax_number": "337-504-5150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4540 Ambassador Caffery Pkwy Bldg D Ste C200",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "70508",
            "country_code": "US",
            "telephone_number": "337-504-5200",
            "fax_number": "337-504-5150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOX",
        "first_name": "DONNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2022-07-21",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "019491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1092438",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.