Individual provider Active NPI

Ann Marie Flannery, MD

  • Neurological Surgery Physician
  • Lafayette, LA
National Provider Identifier
1558465161
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
207442 Issued in LA
Practice address
4704 Ambassador Caffery Pkwy
Lafayette, LA 70508-6908
Phone
(337) 470-5920
Fax
(337) 371-3154
NPI assigned
Sep 12, 2006
Last updated
Jan 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 207442 LA Primary
Neurological Surgery Physician 207T00000X 2003010755 MO

Addresses

Primary practice location

4704 Ambassador Caffery Pkwy
Lafayette, LA 70508-6908

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (337) 470-5920

Other practice location 1

1465 S Grand Blvd
Cardinal Glennon Neurosurgery
Saint Louis, MO 63104-1003
Phone (314) 577-5306

Other practice location 2

4704 Ambassador Caffery Pkwy Fl 2
Lafayette, LA 70508-6908
Phone (337) 470-5920

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other
Direct Messaging Address aflannery269868@direct.casso.us.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150102001157 LA Practitioner - Neurosurgery 5092873844 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
207442LAMDNeurological Surgery Physician
2003010755MOMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Dec 1, 2021 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Dec 1, 2021 Accepting new patients
Lourdes Physician Group LLC CurrentSince Mar 1, 2019 Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

4704 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-5920

4704 Ambassador Caffery Pkwy
Fl 2
Lafayette, LA 70508
Phone (337) 470-5920

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

1890 W Gauthier Rd
Ste 115
Lake Charles, LA 70605
Phone (337) 371-3101

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1558465161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "337-470-5920",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4704 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086908",
            "telephone_number": "337-470-5920",
            "fax_number": "337-371-3154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1465 S Grand Blvd",
            "address_2": "Cardinal Glennon Neurosurgery",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041003",
            "country_code": "US",
            "telephone_number": "314-577-5306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4704 Ambassador Caffery Pkwy Fl 2",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705086908",
            "country_code": "US",
            "telephone_number": "337-470-5920",
            "fax_number": "855-431-6867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLANNERY",
        "first_name": "ANN MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "LA",
            "license": "207442",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "2003010755",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4704 Ambassador Caffery Pkwy",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705086908",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aflannery269868@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "aflannery269868@direct.casso.us.com",
            "address_1": "4704 Ambassador Caffery Pkwy",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705086908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.