Individual provider Active NPI

Donna Jeanne Vial, PA

  • Physician Assistant
  • Lafayette, LA
National Provider Identifier
1306878186
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0000001234 Issued in TN
Practice address
1245 Camellia Blvd Ste 300
Lafayette, LA 70508-7219
Phone
(337) 839-2773
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0000001234 TN Primary

Addresses

Primary practice location

1245 Camellia Blvd Ste 300
Lafayette, LA 70508-7219

Mailing address

6411 Perkins Rd Ste 100
Baton Rouge, LA 70808-4125
Phone (225) 303-9500

Other identifiers 1

IdentifierTypeStateIssuer
PA.A10442OtherLAMEDICAL LICENSE

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
I20171221000297 LA Practitioner - Physician Assistant 8729014535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Center of Acadiana LLCGroup PAC ID 5991067019, 3 clinicians

Practice addresses (Care Compare)

1245 S College Rd
BLDG 5
Lafayette, LA 70503-2917
Phone (337) 235-6886

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0000001234TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Dermatology Group PA Past Accepting new patients

Organizations & group practices 2

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 1

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1306878186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 PERKINS RD STE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084125",
            "telephone_number": "225-303-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 CAMELLIA BLVD STE 300",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087219",
            "telephone_number": "337-839-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIAL",
        "first_name": "DONNA",
        "middle_name": "JEANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000001234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA.A10442",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.