Individual provider Active NPI

Charmaine Landry Hebert, NP

  • Family Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1225341019
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06194 Issued in LA
Practice address
3220 Kaliste Saloom Rd
Lafayette, LA 70508
Phone
(337) 470-3370
Fax
(337) 470-4402
NPI assigned
Jul 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP06194 LA Primary
Nurse Practitioner 363L00000X RN075247 AP06194 LA

Addresses

Primary practice location

3220 Kaliste Saloom Rd
Lafayette, LA 70508

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (337) 470-3370

Other practice location 1

2647 S Saint Elizabeth Blvd Ste 308
Gonzales, LA 70737-5020
Phone (225) 765-5500

Other identifiers 1

IdentifierTypeStateIssuer
2121090MedicaidLA

Other names 1

  • Ms. Charmaine Landry Cuccia Former name

Electronic endpoints 4

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other
Direct Messaging Address ccuccia7392@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other
Direct Messaging Address ccuccia7392@direct.casso.us.com Direct

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
I20100827000602 LA Practitioner - Nurse Practitioner 6507980646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Louisiana State University School of Medicine in New Orleans, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lourdes Physician Group LLCGroup PAC ID 7214177757, 157 clinicians

Practice addresses (Care Compare)

3220 Kaliste Saloom Rd
Suite a
Lafayette, LA 70508-7422
Phone (337) 470-3370

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2990

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN075247 AP06194LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Oct 13, 2022 Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner CurrentSince Oct 13, 2022 Accepting new patients
Lourdes Physician Group LLC Nurse Practitioner CurrentSince Jul 29, 2013 Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner Past Accepting new patients
Our Lady of Lourdes Regional Medical Center Past Accepting new patients

Locations

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

2647 S Saint Elizabeth Blvd
Ste 308
Gonzales, LA 70737
Phone (225) 647-5017

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

4525 Ambassador Caffery Pkwy
Lafayette, LA 70508

3220 Kaliste Saloom Rd
Lafayette, LA 70508
Phone (337) 406-9474

Interoperability endpoints

  • Direct secure messaging: ccuccia7392@direct.casso.us.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1225341019",
    "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": "337-470-3370",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 KALISTE SALOOM RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "337-470-3370",
            "fax_number": "337-470-4402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2647 S Saint Elizabeth Blvd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "LA",
            "postal_code": "707375020",
            "country_code": "US",
            "telephone_number": "225-765-5500",
            "fax_number": "225-765-9419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "CHARMAINE",
        "middle_name": "LANDRY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06194",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN075247 AP06194",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2121090",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3220 Kaliste Saloom Rd",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccuccia7392@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccuccia7392@direct.casso.us.com",
            "address_1": "3220 Kaliste Saloom Rd",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2647 S Saint Elizabeth Blvd Ste 308",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707375020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccuccia7392@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccuccia7392@direct.casso.us.com",
            "address_1": "2647 S Saint Elizabeth Blvd Ste 308",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707375020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHARMAINE",
            "last_name": "CUCCIA",
            "middle_name": "LANDRY",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.