Individual provider Active NPI

Drake A Degrange, MD

  • Anesthesiology Physician
  • Houma, LA
National Provider Identifier
1184656357
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
013123 Issued in LA
Practice address
1990 Industrial Blvd
Houma, LA 70363-7055
Phone
(985) 868-9300
Fax
(985) 851-0053
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 013123 LA Primary

Addresses

Primary practice location

1990 Industrial Blvd
Houma, LA 70363-7055

Mailing address

1990 Industrial Blvd
Houma, LA 70363-7055
Phone (985) 868-9300

Other identifiers 1

IdentifierTypeStateIssuer
1157341MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
013123LAMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1184656357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 INDUSTRIAL BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-868-9300",
            "fax_number": "985-851-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 INDUSTRIAL BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-868-9300",
            "fax_number": "985-851-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRANGE",
        "first_name": "DRAKE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "013123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1157341",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.