Individual provider Active NPI

Edward Kemp Coreil, MD

  • Internal Medicine Physician
  • Lafayette, LA
National Provider Identifier
1407887441
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.12561R Issued in LA
Practice address
105 Patriot St Ste 202
Lafayette, LA 70508-6831
Phone
(337) 504-7979
Fax
(337) 534-0252
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.12561R LA Primary

Addresses

Primary practice location

105 Patriot St Ste 202
Lafayette, LA 70508-6831

Mailing address

105 Patriot St Ste 202
Lafayette, LA 70508-6831
Phone (337) 504-7979

Other names 1

  • Kemp Coreil Professional name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040716000017 LA Practitioner - Internal Medicine 2567441488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SW Louisiana Internal Medicine LLCGroup PAC ID 8325450059, 2 clinicians

Practice addresses (Care Compare)

105 Patriot St
Suite 202
Lafayette, LA 70508-6831
Phone (337) 257-2838

Hospital & facility affiliations

  • Nursing Specialties Home health agency, Lafayette, LA, CCN 197297
  • Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
  • Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.12561RLAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SW Louisiana Internal Medicine LLC Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients

Locations

105 Patriot St
Ste 202
Lafayette, LA 70508
Phone (337) 257-2838

Interoperability endpoints

  • Direct secure messaging: edward.coreil.1@22993.direct.athenahealth.com

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 3

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1407887441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PATRIOT ST STE 202",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086831",
            "telephone_number": "337-504-7979",
            "fax_number": "337-534-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PATRIOT ST STE 202",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086831",
            "telephone_number": "337-504-7979",
            "fax_number": "337-534-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COREIL",
        "first_name": "EDWARD",
        "middle_name": "KEMP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.12561R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEMP",
            "last_name": "COREIL",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.