Individual provider Active NPI

Michelle W Adams, FNP-C

  • Family Nurse Practitioner
  • Deridder, LA
National Provider Identifier
1124694989
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
211983 Issued in LA
Practice address
1017 N Pine St
Deridder, LA 70634-2817
Phone
(337) 202-4101
Fax
(337) 202-4052
NPI assigned
Jun 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 211983 LA Primary

Addresses

Primary practice location

1017 N Pine St
Deridder, LA 70634-2817

Mailing address

1017 N Pine St
Deridder, LA 70634-2817
Phone (337) 202-4101

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210807000198 LA Practitioner - Nurse Practitioner 4789088113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Janardana P. Kaimal, MD LLCGroup PAC ID 3476639162, 3 clinicians

Practice addresses (Care Compare)

4820 Lake St
Lake Charles, LA 70605-6010
Phone (337) 310-7378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
211983LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Calcasieu Urgent Care, LLC CurrentSince Aug 2, 2021 Accepting new patients
Calcasieu Urgent Care LLC CurrentSince Aug 2, 2021 Accepting new patients
Sleep Disorder Center of Louisiana, LLC Current Accepting new patients
Janardana P. Kaimal, MD, LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

501 S Pine St
Deridder, LA 70634
Phone (337) 462-3937

1017 N Pine St
Deridder, LA 70634
Phone (337) 202-4101

2800 W Pinhook Rd
Ste 9
Lafayette, LA 70508
Phone (337) 419-0904

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

4820 Lake St
Lake Charles, LA 70605
Phone (337) 310-7378

Interoperability endpoints

  • Direct secure messaging: michelleadams@sdcl.allscriptsdirect.net

Organizations & group practices 4

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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1124694989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 N PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706342817",
            "telephone_number": "337-202-4101",
            "fax_number": "337-202-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 N PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706342817",
            "telephone_number": "337-202-4101",
            "fax_number": "337-202-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "MICHELLE",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "211983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

Verify at the official NPI Registry.