Active NPI
Penni Fontenot
- Social Worker
- Lafayette, LA
National Provider Identifier
1427597871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 12209
- Practice address
- 1017 Saint John St
Lafayette, LA 70501-6711 - Phone
- (337) 261-2300
- NPI assigned
- Feb 17, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 12209 | LA | Primary |
Addresses
Primary practice location
1017 Saint John St
Lafayette, LA 70501-6711
Mailing address
2525 Youree Dr Ste 110
Shreveport, LA 71104-3600
Phone (318) 742-3408
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2013
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1535 W Main St
Ville Platte, LA 70586-4320
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12209 | LA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vital Healthcare Solutions LLC | Current | Accepting new patients |
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.
-
- Rural Health Clinic/Center
- Ville Platte, LA
- NPI 1598473415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487289600000",
"number": "1427597871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 YOUREE DR STE 110",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711043600",
"telephone_number": "318-742-3408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 SAINT JOHN ST",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705016711",
"telephone_number": "337-261-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTENOT",
"first_name": "PENNI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-17",
"last_updated": "2017-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "LA",
"license": "12209",
"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 Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.