Individual provider Active NPI

Lisa Russo Authement, MSN-APRN

  • Family Nurse Practitioner
  • Houma, LA
National Provider Identifier
1417143249
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP05301 Issued in LA
Practice address
911 Verret St
Houma, LA 70360-4637
Phone
(985) 876-7388
Fax
(985) 872-2878
NPI assigned
Sep 14, 2007
Last updated
Jun 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP05301 LA Primary
Registered Nurse 163W00000X RN078449 LA

Addresses

Primary practice location

911 Verret St
Houma, LA 70360-4637

Mailing address

911 Verret St
Houma, LA 70360-4637
Phone (985) 876-7388

Other identifiers 1

IdentifierTypeStateIssuer
1030431MedicaidLA

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
I20070926000605 LA Practitioner - Nurse Practitioner 9133214836 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Medical GroupGroup PAC ID 4688977549, 10 clinicians

Practice addresses (Care Compare)

1340 Grand Caillou Rd
Houma, LA 70363-5558
Phone (985) 262-4424

1505 Hwy 90 E
Morgan City, LA 70380-5374
Phone (985) 745-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN078449LAMDRegistered Nurse
AP05301LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Calcasieu Urgent Care, LLC CurrentSince Nov 10, 2021 Accepting new patients
Delta Medical Group CurrentSince Jun 15, 2024 Accepting new patients
Physician Practice Partners CurrentSince Feb 5, 2017 Accepting new patients
Calcasieu Urgent Care LLC CurrentSince Nov 10, 2021 Accepting new patients
Internal Medicine Clinic of Houma CurrentSince May 22, 2013 Accepting new patients

Locations

1340 Grand Caillou Rd
Houma, LA 70363
Phone (985) 262-4424

911 Verret St
Houma, LA 70360
Phone (985) 876-7388

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

1505 Highway 90 E
Morgan City, LA 70380
Phone (985) 745-6000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1417143249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 VERRET ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604637",
            "telephone_number": "985-876-7388",
            "fax_number": "985-872-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 VERRET ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604637",
            "telephone_number": "985-876-7388",
            "fax_number": "985-872-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTHEMENT",
        "first_name": "LISA",
        "middle_name": "RUSSO",
        "credential": "MSN-APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP05301",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN078449",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030431",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.