Provisionam

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROVISIONAM

Doing business as

ProvisioAm, LLC

Practice address

3819 Phelan Blvd
Beaumont, TX 77707-2243

Phone

(409) 363-5022

Fax

(409) 363-5015

NPI assigned

Mar 6, 2019

Last updated

Mar 6, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carline Pierre-Louis CenatusNPI 1386972172

Title

Owner

Phone

(239) 404-9870

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProvisioAm, LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carline Pierre-Louis Cenatus, PA

  • Physician Assistant
  • Beaumont, TX
  • NPI 1386972172
  NPD (past) Authorized official

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1235697426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 SUNFLOWER ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777139214",
            "telephone_number": "239-404-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3819 PHELAN BLVD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777072243",
            "telephone_number": "409-363-5022",
            "fax_number": "409-363-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISIONAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "CENATUS",
        "authorized_official_first_name": "CARLINE",
        "authorized_official_middle_name": "PIERRE-LOUIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-404-9870"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProvisioAm, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jay C. Proctor III, MD
• Corey Lynn Proenza
• Pronto Medical Services
• Prosthetic Solution Centers of America, LLC (Prosthetic Solution Center)
• Provision Imaging of Beaumont
• Joseph W Provo III, DDS
• Brazhona Prudhomme
• Stacy Lynn Pruitt, RD, LD
• Gita Chetty Pulley, O. D.
• Pulse Homecare, LTD. (Pulse Homecare)

• Durable Medical Equipment & Medical Supplies in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.