Joan Tabatha Fisher-Ranel, DDS
Individual provider Active NPI Dentist · Baker, LA
NPI 1225330558 · NPPES record last updated Nov 18, 2010
Key facts
- NPI
- 1225330558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4877 (LA)
- Practice address
- 12841 Plank Rd
Suite a
Baker, LA 70714-4908 - Phone
- (225) 775-3552
- Fax
- (225) 775-3569
- NPI assigned
- Nov 18, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250109000242 | LA | Practitioner - Dentist | 7810298031 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4877 | LA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Community Health Systems | Current | Accepting new patients | |
| Southeast Community Health Systems | Current |
Accepting new patients | |
| Southeast Community Health Systems | Current |
Accepting new patients | |
| Southeast Community Health Systems | Current | Accepting new patients | |
| All Smiles Dental Center Inc | Past | Accepting new patients |
Locations
490 Sitman St
Greensburg, LA 70441
Phone (225) 222-6059
336 E Railroad Ave
Independence, LA 70443
Phone (225) 306-2060
6351 Main St
Zachary, LA 70791
Phone (225) 306-2055
Interoperability endpoints
- joan.ranel@shchc.directbygreenway.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4877 | LA | Yes |
Addresses
Primary practice location
12841 Plank Rd
Suite a
Baker, LA 70714-4908
Mailing address
12841 Plank Rd
Suite a
Baker, LA 70714-4908
Phone (225) 775-3552
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1848778 | Medicaid | LA |
Other providers in Baker, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.