Active NPI
Erin Paige Defatta, DC
- Chiropractor
- Mandeville, LA
National Provider Identifier
1154915908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1919
- Practice address
- 102 Fontainbleau Dr # D1
Mandeville, LA 70471-6518 - Phone
- (985) 400-5300
- NPI assigned
- Feb 23, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1919 | LA | Primary |
Addresses
Primary practice location
102 Fontainbleau Dr # D1
Mandeville, LA 70471-6518
Mailing address
102 Fontainbleau Dr # D1
Mandeville, LA 70471-6518
Phone (985) 400-5300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210302002811 | LA | Practitioner - Chiropractic | 6507272317 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
58465 Tyler St
Suite 15
Slidell, LA 70461-3937
Phone (985) 400-5300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1919 | LA | MD | Registered Dietitian |
Organizations & group practices 1
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": "1614038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614038400000",
"number": "1154915908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 FONTAINBLEAU DR # D1",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704716518",
"telephone_number": "985-400-5300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 FONTAINBLEAU DR # D1",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704716518",
"telephone_number": "985-400-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFATTA",
"first_name": "ERIN",
"middle_name": "PAIGE",
"name_prefix": "Miss",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-23",
"last_updated": "2021-02-23",
"certification_date": "2021-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "LA",
"license": "1919",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mandeville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.