Individual provider Active NPI

Geronna Martin Leonards, NP

  • Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1417217860
Registry record updated May 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP06812 Issued in LA
Practice address
1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone
(770) 874-5439
Fax
(770) 874-5483
NPI assigned
May 19, 2012
Last updated
May 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP06812 LA Primary

Addresses

Primary practice location

1214 Coolidge Blvd
Lafayette, LA 70503-2621

Mailing address

205 Lake Cove Rd
Rayne, LA 70578-7679
Phone (337) 334-2525

Other names 1

  • Geronna Deidre Martin Former 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120607000115 LA Practitioner - Nurse Practitioner 3173787983 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Opelousas Emergency Group LLC Nurse Practitioner CurrentSince Apr 10, 2013 Accepting new patients
Crowley Emergency Group LLC Nurse Practitioner CurrentSince Feb 15, 2015 Accepting new patients
Abbeville Emergency Group LLC Nurse Practitioner CurrentSince Oct 24, 2015 Accepting new patients
Coolidge Emergency Group LLC Nurse Practitioner CurrentSince Dec 1, 2012 Accepting new patients
Louisiana Emergency Physicians, LLC Past Accepting new patients
Pediatric Medical Group of Santa Maria Inc Past Accepting new patients

Locations

118 N Hospital Dr
Abbeville, LA 70510
Phone (337) 893-5466

1305 E Highway 90
Crowley, LA 70526
Phone (337) 783-3222

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

539 E Prudhomme St
Opelousas, LA 70570
Phone (337) 943-7128

Interoperability endpoints

  • Direct secure messaging: geronna.leonards.1@32391.direct.athenahealth.com

Organizations & group practices 6

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": "1337385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337385600000",
    "number": "1417217860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 LAKE COVE RD",
            "city": "RAYNE",
            "state": "LA",
            "postal_code": "705787679",
            "telephone_number": "337-334-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 COOLIDGE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032621",
            "telephone_number": "770-874-5439",
            "fax_number": "770-874-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARDS",
        "first_name": "GERONNA",
        "middle_name": "MARTIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-19",
        "last_updated": "2012-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP06812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GERONNA",
            "last_name": "MARTIN",
            "middle_name": "DEIDRE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.