Individual provider Active NPI

Suzette Bonneval, RPH

  • Pharmacist
  • Lafayette, LA
National Provider Identifier
1366064388
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
013855 Issued in LA
Practice address
2390 W Congress St
Lafayette, LA 70506-4205
Phone
(337) 261-6238
NPI assigned
May 13, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
013855LAMDPharmacist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 013855 LA Primary

Addresses

NPPES NPI Registry

Primary practice location

2390 W Congress St
Lafayette, LA 70506-4205

Mailing address

1605 Ben Hogan Drive
New Iberia, LA 70563
Phone (337) 380-5405

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 13, 2020.

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1366064388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 BEN HOGAN DRIVE",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "70563",
            "telephone_number": "337-380-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 W CONGRESS ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064205",
            "telephone_number": "337-261-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEVAL",
        "first_name": "SUZETTE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "013855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.