Individual provider Active NPI

Caroline Landry Hanks, PA-C

  • Physician Assistant
  • Lafayette, LA
National Provider Identifier
1215615539
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
337798 Issued in LA
Practice address
4704 Ambassador Caffery Pkwy FL 1
Lafayette, LA 70508-6908
Phone
(337) 470-5920
Fax
(885) 431-6868
NPI assigned
Jul 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 337798 LA Primary

Addresses

Primary practice location

4704 Ambassador Caffery Pkwy FL 1
Lafayette, LA 70508-6908

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (337) 470-5920

Other practice location 1

1890 W Gauthier Rd Ste 115
Lake Charles, LA 70605-7180
Phone (337) 470-2907

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
I20230728000030 LA Practitioner - Physician Assistant 2466813100 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Jul 31, 2023 Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

8200 Constantin Blvd
Fl 1
Baton Rouge, LA 70809

4704 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-5920

4704 Ambassador Caffery Pkwy
#F
Lafayette, LA 70508

4704 Ambassador Caffery Pkwy
#1
Lafayette, LA 70508

4704 Ambassador Caffery Pkwy
Fl 1
Lafayette, LA 70508
Phone (337) 371-3101

Interoperability endpoints

  • Direct secure messaging: chanks3203759@direct.casso.us.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1215615539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "337-470-5920",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4704 AMBASSADOR CAFFERY PKWY FL 1",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086908",
            "telephone_number": "337-470-5920",
            "fax_number": "885-431-6868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1890 W Gauthier Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706057180",
            "country_code": "US",
            "telephone_number": "337-470-2907",
            "fax_number": "855-431-6868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANKS",
        "first_name": "CAROLINE",
        "middle_name": "LANDRY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "337798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.