Individual provider Active NPI

Patricia D. McGovern, NP

  • Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1134313331
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN047758 AP05181 Issued in LA
Practice address
100 Asma Blvd BLDG 1 Suite 205
Lafayette, LA 70508
Phone
(337) 470-3486
Fax
(337) 289-5609
NPI assigned
Aug 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN047758 AP05181 LA Primary

Addresses

Primary practice location

100 Asma Blvd BLDG 1 Suite 205
Lafayette, LA 70508

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (337) 470-3486

Other practice location 1

401 E Vaughn Ave Ste 104-105
Ruston, LA 71270-5950
Phone (318) 224-7190

Other identifiers 1

IdentifierTypeStateIssuer
1029050MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pmcgovern1945840@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

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
I20070926000282 LA Practitioner - Nurse Practitioner 8527152297 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Our Lady of Lourdes Regional Medical Center, Inc.Group PAC ID 5890683411, 15 clinicians

Practice addresses (Care Compare)

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2000

Hospital & facility affiliations

  • Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN047758 AP05181LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
A Plus Medical of Ruston LLC CurrentSince May 1, 2019 Accepting new patients
Our Lady of Lourdes Regional Medical Center Inc CurrentSince Feb 17, 2021 Accepting new patients
Our Lady of Lourdes Regional Medical Center CurrentSince Feb 17, 2021 Accepting new patients
A Plus Medical of Ruston LLC CurrentSince May 1, 2019 Accepting new patients
Butler-Abshire Medical Clinic, Apmc Past Accepting new patients
Our Lady of Lourdes Regional Medical Center Past Accepting new patients

Locations

1325 Wright Ave
Ste I
Crowley, LA 70526
Phone (337) 470-3570

100 Asma Blvd
Ste 205
Lafayette, LA 70508
Phone (337) 205-1012

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

Interoperability endpoints

  • Direct secure messaging: pmcgovern1945840@direct.casso.us.com

Organizations & group practices 6

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1134313331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "337-470-3486",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ASMA BLVD BLDG 1 SUITE 205",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "337-470-3486",
            "fax_number": "337-289-5609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 E Vaughn Ave Ste 104-105",
            "address_purpose": "LOCATION",
            "city": "Ruston",
            "state": "LA",
            "postal_code": "712705950",
            "country_code": "US",
            "telephone_number": "318-224-7190",
            "fax_number": "318-704-7194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "PATRICIA",
        "middle_name": "D.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN047758 AP05181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029050",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmcgovern1945840@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pmcgovern1945840@direct.casso.us.com",
            "address_1": "100 Asma Blvd Bldg 1 Suite 205",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "100 Asma Blvd Bldg 1 Suite 205",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.