Individual provider Active NPI

Radhiya Kibibi Lewis, FNP

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1316145345
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP04943 Issued in LA
Practice address
8913 Bluebonnet Blvd Ste a
Baton Rouge, LA 70810-2974
Phone
(225) 612-3900
Fax
(225) 612-3800
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP04943 LA Primary

Addresses

Primary practice location

8913 Bluebonnet Blvd Ste a
Baton Rouge, LA 70810-2974

Mailing address

8913 Bluebonnet Blvd Ste a
Baton Rouge, LA 70810-2974
Phone (225) 612-3900

Other identifiers 1

IdentifierTypeStateIssuer
1350559MedicaidLA

Other names 1

  • Radiya Kibibi Rashadeen Former name

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
I20100106000245 LA Practitioner - Nurse Practitioner 3476694977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HIV-AIDS Alliance for Region TwoGroup PAC ID 4880981158, 18 clinicians

Practice addresses (Care Compare)

781 Colonial Dr
Baton Rouge, LA 70806-6512
Phone (225) 424-1746

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Department of Health - Office of Public Health CurrentSince May 1, 2018 Accepting new patients
Louisiana Department of Health - Office of Public Health Current Accepting new patients
Southeast Community Health Systems PastSince Sep 12, 2021 Accepting new patients

Locations

5604 Coliseum Blvd
Ste A
Alexandria, LA 71303
Phone (318) 487-5282

1029 Capitol Ave
Crowley, LA 70526
Phone (337) 788-7507

111 N Causeway Blvd
Metairie, LA 70001
Phone (504) 482-0084

1450 Poydras St
New Orleans, LA 70112
Phone (504) 903-2373

685 Louisiana Ave
Port Allen, LA 70767
Phone (225) 342-7525

Interoperability endpoints

  • Direct secure messaging: radhiya.lewis@ldhoph.directbygreenway.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1316145345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8913 BLUEBONNET BLVD STE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708102974",
            "telephone_number": "225-612-3900",
            "fax_number": "225-612-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8913 BLUEBONNET BLVD STE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708102974",
            "telephone_number": "225-612-3900",
            "fax_number": "225-612-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "RADHIYA",
        "middle_name": "KIBIBI",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2024-06-12",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP04943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1350559",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RADIYA",
            "last_name": "RASHADEEN",
            "middle_name": "KIBIBI",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.