NPIMap

Organization Active NPI

Wisdom Healthcare Service LLC

  • Health Service Clinic/Center
  • Lafayette, LA
National Provider Identifier
1114687563
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
WISDOM HEALTHCARE SERVICE LLC
Practice address
109 Boulet Dr
Lafayette, LA 70506-2212
Phone
(337) 279-2102
Fax
(337) 735-1887
NPI assigned
Dec 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Authorized official

Name
Destiny L LandryNPI 1538892559
Title
Ceo
Phone
(337) 230-3116

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X
Health Service Clinic/Center 261QH0100X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

109 Boulet Dr
Lafayette, LA 70506-2212

Mailing address

5520 Johnson Ste K PMB 1121
Lafayette, LA 70503-6706
Phone (337) 279-2102

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1640563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1114687563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 JOHNSON STE K PMB 1121",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705036706",
            "telephone_number": "337-279-2102",
            "fax_number": "337-735-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BOULET DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705062212",
            "telephone_number": "337-279-2102",
            "fax_number": "337-735-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISDOM HEALTHCARE SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-27",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "LANDRY",
        "authorized_official_first_name": "DESTINY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-230-3116"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.