Active NPI
Patrice Michelle Ambrose, M.D.
- Psychiatry Physician
- Lafayette, LA
National Provider Identifier
1184759664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD.09732R
- Practice address
- 302 Dulles Dr
Lafayette, LA 70506-3008 - Phone
- (337) 262-4100
- Fax
- (337) 262-4160
- NPI assigned
- Feb 23, 2007
- Last updated
- Jan 12, 2017
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD.09732R | LA | Primary |
Addresses
Primary practice location
302 Dulles Dr
Lafayette, LA 70506-3008
Mailing address
302 Dulles Dr
Lafayette, LA 70506-3008
Phone (337) 262-4100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09732R | Other | LA | MEDICAL LISCENSE |
| 1993778 | Medicaid | LA |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johnathan Larroquette LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatric/Mental Health Nurse Practitioner
- Lafayette, LA
- NPI 1679310072
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484179200000",
"number": "1184759664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 DULLES DR",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705063008",
"telephone_number": "337-262-4100",
"fax_number": "337-262-4160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 DULLES DR",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705063008",
"telephone_number": "337-262-4100",
"fax_number": "337-262-4160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBROSE",
"first_name": "PATRICE",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2017-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "LA",
"license": "MD.09732R",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LISCENSE",
"identifier": "09732R",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1993778",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.