Pediatric Group of Acadiana LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

PEDIATRIC GROUP OF ACADIANA LLC

Practice address

2825 Grand Point Hwy Lot 6
Henderson, LA 70517-6972

Phone

(337) 454-6238

Fax

(337) 408-1198

NPI assigned

Dec 3, 2024

Organization subpart

No

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

Authorized official

Name

Antoinette Rabenaldt

Title

Credentialing Coordinator

Phone

(337) 330-2576

Specialties & licenses 2

Addresses

Other names 1

• St. Cecilia Family Care Clinic Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Pediatric Group of Acadiana10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

• Pediatric Group of Acadiana LLC

  • Rural Health Clinic/Center
  • Erath, LA
  • NPI 1073973533
  NPD tax ID
• Pediatric Group of Acadiana LLC

  • Rural Health Clinic/Center
  • Church Point, LA
  • NPI 1619471463
  NPD tax ID
• Pediatric Group of Acadiana LLC

  • Rural Health Clinic/Center
  • Crowley, LA
  • NPI 1679126510
  NPD tax ID
• Pediatric Group of Acadiana LLC

  • Rural Health Clinic/Center
  • Kaplan, LA
  • NPI 1922619238
  NPD tax ID
• Pediatric Group of Acadiana, LLC

  • Rural Health Clinic/Center
  • Breaux Bridge, LA
  • NPI 1255941829
  NPD tax ID
• Pediatric Group of Acadiana, LLC

  • Rural Health Clinic/Center
  • New Roads, LA
  • NPI 1477027894
  NPD tax ID
• Pediatric Group of Acadiana, LLC

  • Rural Health Clinic/Center
  • Maurepas, LA
  • NPI 1588138903
  NPD tax ID
• Pediatric Group of Acadiana, LLC

  • Rural Health Clinic/Center
  • Saint Martinville, LA
  • NPI 1922283225
  NPD tax ID
• Roger D Rholdon Jr

  • Pediatric Nurse Practitioner
  • Scott, LA
  • NPI 1366860603
  NPD tax ID

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1336965508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 HACKER ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705604508",
            "telephone_number": "337-330-2576",
            "fax_number": "337-321-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 GRAND POINT HWY LOT 6",
            "city": "HENDERSON",
            "state": "LA",
            "postal_code": "705176972",
            "telephone_number": "337-454-6238",
            "fax_number": "337-408-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC GROUP OF ACADIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "RABENALDT",
        "authorized_official_first_name": "ANTOINETTE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "337-330-2576"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Cecilia Family Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ross Michael Dugas, FNP-BC
• Aimee Guidry, NP

• All providers in Henderson, LA
• Rural Health Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.