Individual provider Active NPI

Grace Ekanem Dinvaut, FNP

  • Family Nurse Practitioner
  • Many, LA
National Provider Identifier
1194031237
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06280 Issued in LA
Practice address
1050 N Robinson St
Many, LA 71449
Phone
(318) 256-8150
Fax
(318) 256-8136
NPI assigned
Aug 26, 2010
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 AP06280 LA Primary

Addresses

Primary practice location

1050 N Robinson St
Many, LA 71449

Mailing address

806 Jefferson Ter
New Iberia, LA 70560-5727
Phone (337) 365-4945

Other practice location 1

806 Jefferson Ter
New Iberia, LA 70560-5727
Phone (337) 365-4945

Other practice location 2

567 Walker St
Merryville, LA 70653-3040
Phone (337) 825-1728

Other practice location 3

317 Dernier St
Saint Martinville, LA 70582-3809
Phone (337) 342-2566

Other practice location 4

1002 12th St
Lafayette, LA 70501-6224
Phone (133) 745-6676

Other practice location 5

1004 Surrey St
Lafayette, LA 70501-6143
Phone (337) 456-6768

Other practice location 6

1009 Charity St
Abbeville, LA 70510-5302
Phone (337) 893-3443

Other practice location 7

298 Nolan Trace Pkwy
Leesville, LA 71446
Phone (337) 392-0110

Other identifiers 4

IdentifierTypeStateIssuer
CDS.041111-APNOtherLACDS
58-2164455OtherTAX ID
PA021170CSOtherLAPRESCRIPTIVE AUTHORITY
2129180MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20101115001085 LA Practitioner - Nurse Practitioner 2466647557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

567 Walker St
Merryville, LA 70653-3040
Phone (318) 256-8150

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP06280LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iberia Comprehensive Community Health Center, Inc. CurrentSince Feb 1, 2014 Accepting new patients
Iberia Comprehensive Community Health Center, Inc. CurrentSince Feb 1, 2014 Accepting new patients
Iberia Comprehensive Community Health Center,Inc. Current Accepting new patients
Iberia Comprehensive Community Health Center, Inc. Past Accepting new patients
Iberia Comprehensive Community Health Center, Inc. Past Accepting new patients

Locations

1009 Charity St
Abbeville, LA 70510
Phone (337) 893-3443

1002 12th St
Lafayette, LA 70501
Phone (337) 534-0107

1004 Surrey St
Lafayette, LA 70501
Phone (337) 456-6768

298 Nolan Trce
Leesville, LA 71446
Phone (337) 392-0110

1050 N Robinson St
Many, LA 71449
Phone (318) 256-8150

567 Walker St
Merryville, LA 70653
Phone (337) 365-4945

806 Jefferson Ter
New Iberia, LA 70560
Phone (337) 365-4945

317 Dernier St
Saint Martinville, LA 70582
Phone (337) 342-2566

Interoperability endpoints

  • Direct secure messaging: grace.dinvaut@icchc.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1194031237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-365-4945",
            "fax_number": "318-256-8136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N ROBINSON ST",
            "city": "MANY",
            "state": "LA",
            "postal_code": "71449",
            "telephone_number": "318-256-8150",
            "fax_number": "318-256-8136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "806 Jefferson Ter",
            "address_purpose": "LOCATION",
            "city": "New Iberia",
            "state": "LA",
            "postal_code": "705605727",
            "country_code": "US",
            "telephone_number": "337-365-4945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "567 Walker St",
            "address_purpose": "LOCATION",
            "city": "Merryville",
            "state": "LA",
            "postal_code": "706533040",
            "country_code": "US",
            "telephone_number": "337-825-1728",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "317 Dernier St",
            "address_purpose": "LOCATION",
            "city": "Saint Martinville",
            "state": "LA",
            "postal_code": "705823809",
            "country_code": "US",
            "telephone_number": "337-342-2566",
            "fax_number": "337-342-2392",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1002 12th St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705016224",
            "country_code": "US",
            "telephone_number": "133-745-6676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1004 Surrey St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705016143",
            "country_code": "US",
            "telephone_number": "337-456-6768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1009 Charity St",
            "address_purpose": "LOCATION",
            "city": "Abbeville",
            "state": "LA",
            "postal_code": "705105302",
            "country_code": "US",
            "telephone_number": "337-893-3443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "298 Nolan Trace Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesville",
            "state": "LA",
            "postal_code": "71446",
            "country_code": "US",
            "telephone_number": "337-392-0110",
            "fax_number": "337-392-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DINVAUT",
        "first_name": "GRACE",
        "middle_name": "EKANEM",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2023-03-07",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "CDS.041111-APN",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "58-2164455",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIPTIVE AUTHORITY",
            "identifier": "PA021170CS",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2129180",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Many, LA

Sources for this page

Verify at the official NPI Registry.