NP Med of Acadiana LLC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

NP MED OF ACADIANA LLC

Practice address

4811 Ambassador Caffery Pkwy FL 4
Lafayette, LA 70508-7265

Phone

(305) 322-5100

NPI assigned

Mar 25, 2021

Organization subpart

No

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

Authorized official

Name

Keiffer Bengie Wyble, APRN, NPNPI 1083067144

Title

Sole Owner

Phone

(305) 322-5100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keiffer Bengie Wyble, AGACNP

  • Rehabilitation Clinical Nurse Specialist
  • Lafayette, LA
  • NPI 1083067144

  Gerontology

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616630400000",
    "number": "1346827391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 SANDBAR LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087263",
            "telephone_number": "305-832-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 AMBASSADOR CAFFERY PKWY FL 4",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087265",
            "telephone_number": "305-322-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NP MED OF ACADIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "WYBLE",
        "authorized_official_first_name": "KEIFFER",
        "authorized_official_middle_name": "BENGIE",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "305-322-5100",
        "authorized_official_credential": "APRN, NP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Gerontology Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.