Individual provider Active NPI

Coryn Montalto Rodrigue, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Marrero, LA
National Provider Identifier
1407610900
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
234372 Issued in LA
Practice address
1111 Medical Center Blvd Ste S350
Marrero, LA 70072-3186
Phone
(504) 349-6350
Fax
(504) 349-6355
NPI assigned
Feb 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 234372 LA
Adult Health Nurse Practitioner 363LA2200X 234372 LA
Family Nurse Practitioner 363LF0000X 234372 LA Primary

Addresses

Primary practice location

1111 Medical Center Blvd Ste S350
Marrero, LA 70072-3186

Mailing address

154 Destrehan Dr
Destrehan, LA 70047-5061
Phone (504) 460-2099

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
I20240326003877 LA Practitioner - Nurse Practitioner 5193162196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Orleans Physician Services IncGroup PAC ID 5294057824, 177 clinicians

Practice addresses (Care Compare)

1111 Medical Ctr Blvd
Suite S350
Marrero, LA 70072-3186
Phone (504) 349-6350

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Orleans Physician Services Inc Nurse Practitioner CurrentSince Apr 1, 2024 Accepting new patients

Locations

1111 Medical Center Blvd
Ste S350
Marrero, LA 70072
Phone (504) 349-6350

1111 Medical Center Blvd
Ste S
Marrero, LA 70072

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

1100 Poydras St
New Orleans, LA 70163
Phone (504) 527-9952

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1407610900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 DESTREHAN DR",
            "city": "DESTREHAN",
            "state": "LA",
            "postal_code": "700475061",
            "telephone_number": "504-460-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD STE S350",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723186",
            "telephone_number": "504-349-6350",
            "fax_number": "504-349-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUE",
        "first_name": "CORYN",
        "middle_name": "MONTALTO",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "LA",
            "license": "234372",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "234372",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "234372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.