Carla C Costello, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN095103 AP06260 Issued in LA

Practice address

320 N Hood St
Lake Providence, LA 71254-2140

Phone

(318) 559-2404

NPI assigned

Aug 24, 2010

Last updated

Oct 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Group practices

East Carroll Parish HospitalGroup PAC ID 1153216619, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Carroll Parish Hospital Hospital, Lake Providence, LA, CCN 190208
• Fmol Health St Francis Hospital, Monroe, LA, CCN 190125

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carla.costello.1@11988.direct.athenahealth.com

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.

• East Carroll Parish Hospital

  • General Acute Care Hospital
  • Lake Providence, LA
  • NPI 1982695441
  Medicare reassignment Care Compare group NPD
• East Carroll Parish Hospital

  dba Family Medical Clinic-Behavioral Health

  • Federally Qualified Health Center (FQHC)
  • Lake Providence, LA
  • NPI 1508603168
  NPD
• East Carroll Parish Hospital

  dba East Carroll Medical Clinic

  • Rural Health Clinic/Center
  • Lake Providence, LA
  • NPI 1902885650
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Carroll Parish Hospital

  • General Acute Care Hospital
  • Lake Providence, LA
  • NPI 1982695441
  Care Compare affiliation
• St Francis Medical Center, Inc

  • General Acute Care Hospital
  • Monroe, LA
  • NPI 1295723229
  Care Compare affiliation

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1356657746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N HOOD ST",
            "city": "LAKE PROVIDENCE",
            "state": "LA",
            "postal_code": "712542140",
            "telephone_number": "318-559-2404",
            "fax_number": "318-559-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N HOOD ST",
            "city": "LAKE PROVIDENCE",
            "state": "LA",
            "postal_code": "712542140",
            "telephone_number": "318-559-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "CARLA",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN095103  AP06260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2121286",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AP06260",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrington Cammack
• Lena Carter
• Chapman Drugs Inc (Chapman Drug Company)
• CLC of Lake Providence, LLC (Lake Providence Subacute Rehab Center)
• Mary Catherine Coon, RPH
• Lakeisha Moniqe Curley, AS
• Cypress at Lake Providence, LLC (Cypress at Lake Providence)
• Delta Community Action Association, Inc.
• Delta Community Enhancement Program
• Gloria Dixon

• Family Nurse Practitioner in Lake Providence, LA
• Providers in Lake Providence, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.