Individual provider Active NPI

Paula Anne Mitchell, FNP

  • Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1205110582
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN112660-AP06614 Issued in LA
Practice address
4212 W Congress St Ste 2300a
Lafayette, LA 70506-6778
Phone
(372) 377-8013
Fax
(337) 235-1865
NPI assigned
Oct 4, 2011
Last updated
Jul 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN112660-AP06614 LA Primary

Addresses

Primary practice location

4212 W Congress St Ste 2300a
Lafayette, LA 70506-6778

Mailing address

4212 W Congress St Ste 2300a
Lafayette, LA 70506-6778
Phone (372) 377-8013

Other identifiers 1

IdentifierTypeStateIssuer
2183401MedicaidLA

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
I20120321000204 LA Practitioner - Nurse Practitioner 1759541295 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN112660-AP06614LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Martin Hospital, Inc. CurrentSince Apr 3, 2017 Accepting new patients
St. Martin Hospital, Inc. CurrentSince Apr 3, 2017 Accepting new patients
Lafayette Arthritis and Endocrine Clinic Apmc CurrentSince Mar 1, 2018 Accepting new patients
Cardiovascular Institute of the South, LLC Nurse Practitioner PastSince Aug 3, 2009 Accepting new patients

Locations

1555 Gary Dr
#A
Breaux Bridge, LA 70517
Phone (337) 909-2474

210 Champagne Blvd
Breaux Bridge, LA 70517
Phone (337) 332-2178

225 Champagne Blvd
Breaux Bridge, LA 70517
Phone (337) 442-6505

4212 W Congress St
Ste 2300A
Lafayette, LA 70506
Phone (337) 237-7801

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DBHACA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1205110582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 W CONGRESS ST STE 2300A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705066778",
            "telephone_number": "372-377-8013",
            "fax_number": "337-235-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 W CONGRESS ST STE 2300A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705066778",
            "telephone_number": "372-377-8013",
            "fax_number": "337-235-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "PAULA",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN112660-AP06614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2183401",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.