Derussy Emergency Group, LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

DERUSSY EMERGENCY GROUP, LLC

Practice address

4231 Highway 1192
Marksville, LA 71351-4711

Phone

(318) 240-6045

NPI assigned

Jan 28, 2019

Last updated

Mar 23, 2022By 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

Lisha C Falk

Title

VP of Contracting

Phone

(337) 609-1221

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 26

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.

• Jason Adekoya, MD, MPH

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1548846215
  Medicare reassignment Care Compare group NPD
• Robert John Burlet III, MD

  • Family Medicine Physician
  • Sunset, LA
  • NPI 1598727984
  Medicare reassignment Care Compare group NPD
• Patrick Byrne, MD

  • Family Medicine Physician
  • New Orleans, LA
  • NPI 1154076867
  Medicare reassignment Care Compare group NPD
• Robert Babson Fresh, M.D.

  • Family Medicine Physician
  • Alexandria, LA
  • NPI 1437349545
  Medicare reassignment Care Compare group NPD
• Chakshu Gautam, M.D.

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1952303240
  Medicare reassignment Care Compare group NPD
• Gregory Lyon Glowacki, M.D.

  • Emergency Medicine Physician
  • Breaux Bridge, LA
  • NPI 1710917414
  Medicare reassignment Care Compare group NPD
• Shea Inman, MD

  • Family Medicine Physician
  • Youngsville, LA
  • NPI 1275282709
  Medicare reassignment Care Compare group NPD
• Lilla Lendvai

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1881272607
  Medicare reassignment Care Compare group NPD
• Allen W McClure III, MD

  • Surgery Physician
  • Marksville, LA
  • NPI 1801893458
  Medicare reassignment Care Compare group NPD
• Christopher L. Ritter, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Many, LA
  • NPI 1174577902
  Medicare reassignment Care Compare group NPD
• Mark A. St. Cyr, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Lafayette, LA
  • NPI 1184678997
  Medicare reassignment Care Compare group NPD
• Austin Trevor Williams, MD

  • Family Medicine Physician
  • Marksville, LA
  • NPI 1265994222

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1306300900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4231 HIGHWAY 1192",
            "city": "MARKSVILLE",
            "state": "LA",
            "postal_code": "713514711",
            "telephone_number": "318-240-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERUSSY EMERGENCY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-28",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "LISHA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP OF CONTRACTING",
        "authorized_official_telephone_number": "337-609-1221"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2492632",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy Pauline Dauzat, N.P
• Gabrielle David
• Kurt Gerard Demars, LPC
• Sara Laborde Demars, FNP-C
• Department of Health and Hospitals (Avoyelles Mental Health Clinic)
• Nettie L Desselle, PTA
• Dr. Robert W. Johnson, L.L.C.
• Angel Ducote
• Dana Leigh Ducote
• Kelsey R Ducote, CCC-SLP

• Emergency Medicine Physician in Marksville, LA
• Providers in Marksville, LA by specialty
• Emergency Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.