Organization Active NPI

Lafayette Dermatology, LLC

  • Dermatology Physician
  • Lafayette, LA
National Provider Identifier
1164773172
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
LAFAYETTE DERMATOLOGY, LLC
Practice address
101 Rue Fontaine BLDG 1
Lafayette, LA 70508-5788
Phone
(337) 524-1700
NPI assigned
Oct 1, 2012
Last updated
Sep 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Authorized official

Name
Frankie G Rholdon, MDNPI 1528252681
Title
Director
Phone
(337) 524-1700

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

101 Rue Fontaine BLDG 1
Lafayette, LA 70508-5788

Mailing address

101 Rue Fontaine BLDG 1
Lafayette, LA 70508-5788
Phone (337) 524-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121025000682 LA Part B Supplier - Clinic/Group Practice 8325298490 Receives reassigned benefits from 8 practitioners
Practice locations: Lafayette, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2117917Lafayette Dermatology, LLC101 Rue Fontaine BLDG 1, Lafayette, LA 70508Certificate of waiverAug 24, 2026

National Provider Directory

National Provider Directory

Locations

101 Rue Fontaine
Bldg 1
Lafayette, LA 70508
Phone (337) 524-1700

91 Settlers Trace Blvd
Ste 3
Lafayette, LA 70508
Phone (337) 524-1700

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1164773172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RUE FONTAINE BLDG 1",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085788",
            "telephone_number": "337-524-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RUE FONTAINE BLDG 1",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085788",
            "telephone_number": "337-524-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "RHOLDON",
        "authorized_official_first_name": "FRANKIE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "337-524-1700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Sep 25, 2023; 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.

Verify at the official NPI Registry.