Individual provider Active NPI

Carissa Dichelle Dugas, FNP

  • Family Nurse Practitioner
  • Port Arthur, TX
National Provider Identifier
1184472136
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1150010 Issued in TX
Practice address
2548 Memorial Blvd
Port Arthur, TX 77640-2825
Phone
(409) 983-1161
NPI assigned
May 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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 1150010 TX Primary

Addresses

Primary practice location

2548 Memorial Blvd
Port Arthur, TX 77640-2825

Mailing address

2548 Memorial Blvd
Port Arthur, TX 77640-2825
Phone (409) 983-1161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240525000392 TX Order and Referring Only - Nurse Practitioner 0941642607

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1150010TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Health Center Inc Past Accepting new patients

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": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1184472136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 MEMORIAL BLVD",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402825",
            "telephone_number": "409-983-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 MEMORIAL BLVD",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402825",
            "telephone_number": "409-983-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAS",
        "first_name": "CARISSA",
        "middle_name": "DICHELLE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1150010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

Verify at the official NPI Registry.