Krista Dooley Dazzo, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

320127 Issued in LA

Practice address

1202 S Tyler St
Covington, LA 70433-2330

Phone

(985) 898-4438

NPI assigned

Oct 30, 2019

Last updated

Oct 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Calcasieu Urgent Care LLC

  dba Calcasieu Urgent Care

  • Urgent Care Clinic/Center
  • Lake Charles, LA
  • NPI 1467715490
  Medicare reassignment NPD
• Riverside Emergency Physician Partners LLC

  • Emergency Medicine Physician
  • Lafayette, LA
  • NPI 1083107080
  Medicare reassignment
• St Tammany Emergency Physicians Group LLC

  • Emergency Medicine Physician
  • Covington, LA
  • NPI 1891187654
  Medicare reassignment
• Washington Parish Emergency Physicians Group LLC

  • Emergency Medicine Physician
  • Bogalusa, LA
  • NPI 1538511043
  Medicare reassignment
• Calcasieu Urgent Care, LLC

  • Rural Health Clinic/Center
  • Breaux Bridge, LA
  • NPI 1194482398
  NPD

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1144864497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 AMBASSADOR CAFFERY PKWY STE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086984",
            "telephone_number": "337-534-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 S TYLER ST",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332330",
            "telephone_number": "985-898-4438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Main St",
            "address_purpose": "LOCATION",
            "city": "Franklinton",
            "state": "LA",
            "postal_code": "704383688",
            "country_code": "US",
            "telephone_number": "985-839-4431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "433 Plaza St",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704273729",
            "country_code": "US",
            "telephone_number": "985-730-6700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2929 Highway 190",
            "address_purpose": "LOCATION",
            "city": "Mandeville",
            "state": "LA",
            "postal_code": "704713298",
            "country_code": "US",
            "telephone_number": "985-898-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAZZO",
        "first_name": "KRISTA",
        "middle_name": "DOOLEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "320127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Lynn Davis, M.D.
• Stacy Davis, WHNP
• Troy Jean Davis, MD
• Adriene Dawkins, PA
• Jennifer C Day, M.ED. LPC
• De Los Reyes Chiropractic (Simply Precise Chiropractic)
• Frank Pascualin De Paula, M.D.
• Grace De Souza
• Farrah Dean, FNP
• Shawn Dearie, NP

• Physician Assistant in Covington, LA
• Providers in Covington, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.