Individual provider Active NPI

Danette Kelemen Johnson, APRN-CNP

  • Nurse Practitioner
  • New Iberia, LA
National Provider Identifier
1326630260
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
218051 Issued in LA
Practice address
520 N Lewis St FL 2
New Iberia, LA 70563-2094
Phone
(337) 374-7587
Fax
(337) 374-7578
NPI assigned
Feb 10, 2021
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 218051 LA Primary

Addresses

Primary practice location

520 N Lewis St FL 2
New Iberia, LA 70563-2094

Mailing address

301 Ardenwood Dr
Lafayette, LA 70508-7646
Phone (337) 274-4552

Other practice location 1

5701 Ambassador Caffery Pkwy
Youngsville, LA 70592-5181
Phone (337) 456-3323

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
I20210319001641 LA Practitioner - Nurse Practitioner 4880001783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iberia Medical Center Physician Practice NetworkGroup PAC ID 3476730847, 20 clinicians

Practice addresses (Care Compare)

2313 E Main St
Suite C
New Iberia, LA 70560-4091
Phone (337) 364-1734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
218051LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iberia Medical Center Physician Practice Network Nurse Practitioner CurrentSince Mar 1, 2023 Accepting new patients
Hospital Service District No. 1 of Iberia Parish Current Accepting new patients
Myers Dermatology LLC PastSince Feb 1, 2021 Accepting new patients

Locations

2313 E Main St
Ste C
New Iberia, LA 70560
Phone (337) 364-1734

600 N Lewis St
New Iberia, LA 70563
Phone (337) 365-7311

600 N Lewis St
Fl 2
New Iberia, LA 70563
Phone (337) 369-1100

600 N Lewis St
Fl Second
New Iberia, LA 70563

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/ibermed-05842f36

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1326630260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ARDENWOOD DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087646",
            "telephone_number": "337-274-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N LEWIS ST FL 2",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632094",
            "telephone_number": "337-374-7587",
            "fax_number": "337-374-7578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5701 Ambassador Caffery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Youngsville",
            "state": "LA",
            "postal_code": "705925181",
            "country_code": "US",
            "telephone_number": "337-456-3323",
            "fax_number": "337-456-4638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DANETTE",
        "middle_name": "KELEMEN",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "218051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

Verify at the official NPI Registry.