NPIMap

Organization Active NPI

Dauterive Professionals Management

  • Anesthesiology Physician
  • New Iberia, LA
National Provider Identifier
1184658361
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
DAUTERIVE PROFESSIONALS MANAGEMENT
Practice address
600 N Lewis St
New Iberia, LA 70563-2043
Phone
(337) 365-3168
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Authorized official

Name
Ms. Stephanie Boudreaux
Title
Cfo
Phone
(337) 365-2812

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

600 N Lewis St
New Iberia, LA 70563-2043

Mailing address

PO Box 53533
Lafayette, LA 70505-3533
Phone (337) 365-3168

Other identifiers 1

IdentifierTypeStateIssuer
1447030MedicaidLA

Other names 1

  • LST ANESTHESIA Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1184658361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53533",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705053533",
            "telephone_number": "337-365-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N LEWIS ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632043",
            "telephone_number": "337-365-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAUTERIVE PROFESSIONALS MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "BOUDREAUX",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "337-365-2812",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447030",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LST ANESTHESIA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Iberia, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.