Individual provider Active NPI

Marshon M Isaac Sr.

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1366057325
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
214812 Issued in LA
Practice address
1857 Wooddale Blvd
Baton Rouge, LA 70806-1510
Phone
(800) 640-3451
NPI assigned
Sep 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 214812 LA Primary

Addresses

Primary practice location

1857 Wooddale Blvd
Baton Rouge, LA 70806-1510

Mailing address

14470 Stonegate Manor Dr
Gonzales, LA 70737-7593

Other practice location 1

3905 Highway 75
Saint Gabriel, LA 70776-4303
Phone (225) 642-1322

Other practice location 2

1731 Lutcher Ave
Lutcher, LA 70071-5151
Phone (225) 390-0731

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
I20201230002767 LA Practitioner - Nurse Practitioner 6507279064 Reassigns benefits to 2 organizations

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
Spencer J Hardenbrook MD PCGroup PAC ID 2062733546, 93 clinicians

Practice addresses (Care Compare)

Baton Rouge, LA 70806
Phone (800) 640-3451

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214812LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Turnwell Mental Health of South Dakota, PC CurrentSince Mar 16, 2026 Accepting new patients
Coastal Pathways LLC CurrentSince Jul 25, 2021 Accepting new patients
Lake Urgent Care Ascension LLC Past Accepting new patients

Locations

11188 Florida Blvd
Baton Rouge, LA 70815
Phone (225) 275-7570

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": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1366057325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14470 STONEGATE MANOR DR",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707377593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1857 WOODDALE BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708061510",
            "telephone_number": "800-640-3451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3905 Highway 75",
            "address_purpose": "LOCATION",
            "city": "Saint Gabriel",
            "state": "LA",
            "postal_code": "707764303",
            "country_code": "US",
            "telephone_number": "225-642-1322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1731 Lutcher Ave",
            "address_purpose": "LOCATION",
            "city": "Lutcher",
            "state": "LA",
            "postal_code": "700715151",
            "country_code": "US",
            "telephone_number": "225-390-0731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISAAC",
        "first_name": "MARSHON",
        "middle_name": "M",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-15",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "214812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.