Individual provider Active NPI

Nicholas Lawrence Lavin, M.D.

  • Child & Adolescent Psychiatry Physician
  • Lafayette, LA
National Provider Identifier
1417214164
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
207909 Issued in LA
Practice address
913 S College Rd Ste 102
Lafayette, LA 70503-3061
Phone
(337) 232-2833
Fax
(337) 234-4038
NPI assigned
Apr 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 207909 LA Primary

Addresses

Primary practice location

913 S College Rd Ste 102
Lafayette, LA 70503-3061

Mailing address

913 S College Rd Ste 102
Lafayette, LA 70503-3061
Phone (337) 232-2833

Other practice location 1

913 S College Rd Ste 102
Lafayette, LA 70503-3061
Phone (337) 232-2833 ext. 7

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
207909LAMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1417214164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 S COLLEGE RD STE 102",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033061",
            "telephone_number": "337-232-2833",
            "fax_number": "337-234-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 S COLLEGE RD STE 102",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033061",
            "telephone_number": "337-232-2833",
            "fax_number": "337-234-4038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "913 S College Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705033061",
            "country_code": "US",
            "telephone_number": "337-232-2833 x7",
            "fax_number": "337-234-4038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVIN",
        "first_name": "NICHOLAS",
        "middle_name": "LAWRENCE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-19",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "LA",
            "license": "207909",
            "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 Apr 23, 2019; 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.