NPIMap

Individual provider Active NPI

Thomas A Privett, MD

  • Neurology Physician
  • Lafayette, LA
National Provider Identifier
1285632638
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
021911 Issued in LA
Practice address
4811 Ambassador Caffery Pkwy Ste 401B
Lafayette, LA 70508-7265
Phone
(337) 470-4978
Fax
(337) 470-4238
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 23118 SC
Neurology Physician 2084N0400X 021911 LA Primary

Addresses

Primary practice location

4811 Ambassador Caffery Pkwy Ste 401B
Lafayette, LA 70508-7265

Mailing address

9330 Medical Plaza Dr
Charleston, SC 29406
Phone (843) 847-3225

Other practice location 1

9330 Medical Plaza Dr
Charleston, SC 29406
Phone (843) 847-3225

Other identifiers 1

IdentifierTypeStateIssuer
T74087MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211022000884 LA Practitioner - Neurology 1557336203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Tulane University School of Medicine, 1993
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)

4811 Ambassador Caffery Pkwy
Suite 305
Lafayette, LA 70508-7266
Phone (337) 470-3040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
021911LAMDNeurology Physician
34961TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Physician Group LLC CurrentSince Nov 15, 2021 Accepting new patients
Summerville Sleep Consultants LLC PastSince May 5, 2003 Accepting new patients
South Carolina Sleep Medicine LLC Past Accepting new patients

Locations

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

4811 Ambassador Caffery Pkwy
Ste 401B
Lafayette, LA 70508
Phone (337) 470-4978

4811 Ambassador Caffery Pkwy
Ste 305
Lafayette, LA 70508
Phone (337) 470-3040

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

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: thomas.privett@hca5.eclinicaldirectplus.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.

Hospital & facility affiliations 8

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1285632638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 MEDICAL PLAZA DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29406",
            "telephone_number": "843-847-3225",
            "fax_number": "843-847-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 AMBASSADOR CAFFERY PKWY STE 401B",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087265",
            "telephone_number": "337-470-4978",
            "fax_number": "337-470-4238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9330 Medical Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "29406",
            "country_code": "US",
            "telephone_number": "843-847-3225",
            "fax_number": "843-847-3247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIVETT",
        "first_name": "THOMAS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "23118",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "021911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T74087",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.