Opelousas Emergency Group LLC
Organization Active NPI Emergency Medicine Physician · Opelousas, LA
NPI 1477522704 · NPPES record last updated Mar 23, 2022
Key facts
- NPI
- 1477522704
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- OPELOUSAS EMERGENCY GROUP LLC
- Practice address
- 539 E Prudhomme St
Opelousas, LA 70570-6499 - Phone
- (318) 948-3011
- NPI assigned
- Mar 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Lish C Falk
- Title
- VP of Contracting
- Phone
- (337) 609-1221
Practitioners 64
-
Angela Rene Adams, M.D.
-
Stephanie N Aldret, D.O.
-
Kimberly C Allen, APRN
-
Everett J. Bonner Jr., M.D.
-
Glen Paul Carbo, FNP
-
Bryant F. Dronette, PMHNP-BC
-
Keteral James Ducote II, NP-C
-
Joseph Paul Dupre, FNP-C
-
Michael Felton, M.D.
-
Craig Jude Frederick, M.D.
-
Gregory Lyon Glowacki, M.D.
-
Guy Godeaux, MD
-
Eric Tyson Guilbeau, M.D.
-
Brent Eugene Hebert, M.D.
-
Kevin Paul Karam, MD
-
Henry Joseph Kaufman III, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050322000851 | LA | Part B Supplier - Clinic/Group Practice | 7719933829 |
Receives reassigned benefits from 64 practitioners Practice locations: Opelousas, LA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes | ||
| Medical Physician Assistant |
363AM0700X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
539 E Prudhomme St
Opelousas, LA 70570-6499
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1445088 | Medicaid | LA |
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All providers in Opelousas, LA · Emergency Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2022. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.