Family Medicine Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

015812 Issued in LA

Legal business name

FAMILY MEDICINE CLINIC

Practice address

2309 East Main Street
Suite 400
New Iberia, LA 70560

Phone

(337) 367-0271

Fax

(337) 364-6139

NPI assigned

Dec 4, 2007

Last updated

Mar 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jose A Mata, MDNPI 1962402859

Title

Partner

Phone

(337) 367-0271

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20384/brand/1/csg/1/fhir/r4

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jose A Mata, MD

  • Family Medicine Physician
  • New Iberia, LA
  • NPI 1962402859
  Medicare reassignment Care Compare group NPD Authorized official
• George B Cousin, MD

  • Family Medicine Physician
  • New Iberia, LA
  • NPI 1275532186
  Medicare reassignment Care Compare group NPD
• Michelle Lerouge Menard, MD

  • Family Medicine Physician
  • New Iberia, LA
  • NPI 1245439827
  Medicare reassignment Care Compare group NPD
• Ronald Tyler Hebert, MD

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1003310897
  Medicare reassignment NPD
• Caitlin Mitchell McDaniel, MD

  • Family Medicine Physician
  • New Iberia, LA
  • NPI 1902432842
  Medicare reassignment NPD

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1114109923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 EAST MAIN STREET",
            "address_2": "SUITE 400",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "70560",
            "telephone_number": "337-367-0271",
            "fax_number": "337-364-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 EAST MAIN STREET",
            "address_2": "SUITE 400",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "70560",
            "telephone_number": "337-367-0271",
            "fax_number": "337-364-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "MATA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "337-367-0271",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "015812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in New Iberia, LA
• Providers in New Iberia, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.