Kristen Cannon Godeaux, FNP
Individual provider Active NPI Family Nurse Practitioner · Lafayette, LA
NPI 1467093237 · NPPES record last updated Feb 7, 2024
Key facts
- NPI
- 1467093237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 206366 (LA)
- Practice address
- 4650 Ambassador Caffery Pkwy Ste 101
Lafayette, LA 70508-6926 - Phone
- (337) 470-7870
- Fax
- (337) 470-7879
- NPI assigned
- Oct 3, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lourdes Physician Group LLC
Practice addresses (Care Compare)
4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2990
Hospital & facility affiliations
- Grace Home Health
- Our Lady of Lourdes Regional Medical Center, Inc
- Iberia Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200211000060 | LA | Practitioner - Nurse Practitioner | 9032545066 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 206366 | LA | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lourdes Physician Group LLC | Nurse Practitioner | Current |
Accepting new patients |
| Thrive Family Practice LLC | Family | Current |
Accepting new patients |
| Signify Health, LLC | Nurse Practitioner | Current |
Accepting new patients |
| Acadiana Center LLC | Current |
Accepting new patients |
Locations
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011
4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000
4650 Ambassador Caffery Pkwy
Ste 101
Lafayette, LA 70508
Phone (337) 470-7870
2501 W Pinhook Rd
Lafayette, LA 70508
Phone (337) 264-1000
201 Saint Charles Ave
Ste 2500
New Orleans, LA 70170
Phone (504) 582-1416
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Interoperability endpoints
- kgodeaux74049@direct.casso.us.com
- kristen.godeaux@495859721895940.direct.elationemr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 206366 | LA | Yes |
Addresses
Primary practice location
4650 Ambassador Caffery Pkwy Ste 101
Lafayette, LA 70508-6926
Mailing address
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (337) 470-7870
Other practice location 1
2501 W Pinhook Rd
Lafayette, LA 70508-3346
Phone (337) 269-0136
Other providers in Lafayette, LA
- Go Ride LLC
- Go Ride, LLC
- James B. Godchaux Jr.
- James Burton Godchaux Sr.
- Kenneth Bryant Godeaux
- Earl Peter Godfrey Jr.
- Edward Godfrey
- Erika Danielle Godfrey
- Taylor Nicole Godfrey
- Nihal Tejas Godiwala
All providers in Lafayette, LA · Family Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.