Individual provider Active NPI

Amber R Wattigny, AG-ACNP

  • Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1477065381
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP09584 Issued in LA
Practice address
155 Hospital Dr Ste 100
Lafayette, LA 70503-2852
Phone
(337) 235-7743
Fax
(337) 769-0892
NPI assigned
Nov 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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 AP09584 LA Primary

Addresses

Primary practice location

155 Hospital Dr Ste 100
Lafayette, LA 70503-2852

Mailing address

155 Hospital Dr Ste 100
Lafayette, LA 70503-2852

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
I20171228001218 LA Practitioner - Nurse Practitioner 7113285917 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP09584LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurological Associates of Louisiana, L.L.C. CurrentSince Nov 1, 2017 Accepting new patients

Locations

155 Hospital Dr
Ste 100
Lafayette, LA 70503
Phone (337) 235-7743

1103 Kaliste Saloom Rd
Ste 206
Lafayette, LA 70508
Phone (337) 267-1319

Interoperability endpoints

  • Direct secure messaging: awattigny1451577@direct.ochsner.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1477065381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 HOSPITAL DR STE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 HOSPITAL DR STE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032852",
            "telephone_number": "337-235-7743",
            "fax_number": "337-769-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTIGNY",
        "first_name": "AMBER",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "AG-ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP09584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.