NPIMap

Individual provider Active NPI

Erin Nicole Vicknair, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Metairie, LA
National Provider Identifier
1114151578
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD.206074 Issued in LA
Practice address
4200 Houma Blvd
Metairie, LA 70006-2970
Phone
(504) 454-5683
Fax
(504) 456-8195
NPI assigned
May 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD.206074 LA Primary

Addresses

Primary practice location

4200 Houma Blvd
Metairie, LA 70006-2970

Mailing address

4200 Houma Blvd
Metairie, LA 70006-2970
Phone (504) 454-5683

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
I20140826000643 LA Practitioner - Pathology 9830317361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Iowa, RJ & L Carver College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson Pathology LLCGroup PAC ID 5991803355, 2 clinicians

Practice addresses (Care Compare)

4200 Houma Blvd
Metairie, LA 70006-2970
Phone (504) 454-4000

5339 Odonovan Dr
Baton Rouge, LA 70808-4388
Phone (225) 766-4999

Hospital & facility affiliations

  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064
  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176
  • Baton Rouge General Medical Center Hospital, Baton Rouge, LA, CCN 190065
  • Womans Hospital Hospital, Baton Rouge, LA, CCN 190128
  • Lane Regional Medical Center Hospital, Zachary, LA, CCN 190020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.206074LAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Group of Louisiana, a Professional Medical Corporation Anatomic Pathology & Clinical Pathology CurrentSince Dec 1, 2025 Accepting new patients
Pathology Group of Louisiana, a Professional Medical Corporation Anatomic Pathology & Clinical Pathology CurrentSince Dec 1, 2025 Accepting new patients
Jefferson Pathology LLC Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2014 Accepting new patients

Locations

5339 Odonovan Dr
Baton Rouge, LA 70808
Phone (225) 766-4999

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

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 and National Provider Directory roles.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1114151578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062970",
            "telephone_number": "504-454-5683",
            "fax_number": "504-456-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 HOUMA BLVD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062970",
            "telephone_number": "504-454-5683",
            "fax_number": "504-456-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKNAIR",
        "first_name": "ERIN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "LA",
            "license": "MD.206074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.