NPIMap

Organization Active NPI

Iberia Dermatology

  • Dermatology Physician
  • New Iberia, LA
National Provider Identifier
1518094010
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
023184 Issued in LA
Legal business name
IBERIA DERMATOLOGY
Practice address
602 N Lewis St
Suite 600
New Iberia, LA 70563-2093
Phone
(337) 560-1200
Fax
(337) 560-5554
NPI assigned
Feb 28, 2007
Last updated
Oct 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Dr. Venetia Marie Nicole Patout, M.D.NPI 1104849579
Title
Owner
Phone
(337) 560-1200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 023184 LA Primary

Addresses

Primary practice location

602 N Lewis St
Suite 600
New Iberia, LA 70563-2093

Mailing address

PO Box 10938
New Iberia, LA 70562-0938
Phone (337) 560-1200

Other identifiers 1

IdentifierTypeStateIssuer
1492485MedicaidLA

National Provider Directory

National Provider Directory

Locations

602 N Lewis St
Ste 600
New Iberia, LA 70563
Phone (337) 560-1200

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1518094010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10938",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705620938",
            "telephone_number": "337-560-1200",
            "fax_number": "337-560-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N LEWIS ST",
            "address_2": "SUITE 600",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632093",
            "telephone_number": "337-560-1200",
            "fax_number": "337-560-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBERIA DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "PATOUT",
        "authorized_official_first_name": "VENETIA",
        "authorized_official_middle_name": "MARIE NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-560-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "023184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1492485",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.