Individual provider Active NPI

Louis J Croteau, MD

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1104891597
Registry record updated Dec 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101028812 Issued in VA
Practice address
1024 First Colonial Rd
Ste 102
Virginia Beach, VA 23454-3074
Phone
(757) 321-4030
Fax
(757) 275-9700
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2013

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 0101028812 VA Primary

Addresses

Primary practice location

1024 First Colonial Rd
Ste 102
Virginia Beach, VA 23454-3074

Mailing address

1024 First Colonial Rd
Ste 102
Virginia Beach, VA 23454-3074
Phone (757) 321-4030

Other identifiers 1

IdentifierTypeStateIssuer
005621437MedicaidVA

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
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388102400000",
    "number": "1104891597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 FIRST COLONIAL RD",
            "address_2": "STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543074",
            "telephone_number": "757-321-4030",
            "fax_number": "757-275-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 FIRST COLONIAL RD",
            "address_2": "STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543074",
            "telephone_number": "757-321-4030",
            "fax_number": "757-275-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROTEAU",
        "first_name": "LOUIS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2013-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101028812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005621437",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.