Deanna Ibrahim, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

210673 Issued in LA

Practice address

10101 Park Rowe Ave Ste 200
Baton Rouge, LA 70810-1685

Phone

(225) 768-2164

Fax

(833) 756-2680

NPI assigned

Aug 18, 2022

Last updated

Mar 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Louisiana Stat Care LLCGroup PAC ID 3870028491, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Louisiana Stat Care LLC

  • General Practice Physician
  • Baton Rouge, LA
  • NPI 1891517512
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1497473268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 PARK ROWE AVE STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101685",
            "telephone_number": "225-769-2200",
            "fax_number": "833-756-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 PARK ROWE AVE STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101685",
            "telephone_number": "225-768-2164",
            "fax_number": "833-756-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "DEANNA",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "LA",
            "license": "210673",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "210673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE NUMBER",
            "identifier": "210673",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iberville Horizon, LLC
• Ibl Special Care Management Services
• Ibl Special Care Management Services
• Ibl Special Care Management Services
• Ibl Special Care Management Services
• Nazira Nasser Ibrahim, NP
• Alissa Ice, MD
• Iceberg Therapy Services LLC
• Idea Public Schools Nola, Inc.
• Benedict Ekundayo Idowu Sr., D.O.

• Family Nurse Practitioner in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.

Verify at the official NPI Registry.