Individual provider Active NPI

Christian Michael Bertrand, FNP-C

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1558838615
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP10095 Issued in LA
Practice address
2770 3Rd Ave Ste 110
Lake Charles, LA 70601-0404
Phone
(337) 494-4747
Fax
(337) 494-4773
NPI assigned
Oct 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP10095 LA Primary

Addresses

Primary practice location

2770 3Rd Ave Ste 110
Lake Charles, LA 70601-0404

Mailing address

PO Box 122425 Dept 2425
Dallas, TX 75312-2425
Phone (337) 494-4747

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
I20181226000592 LA Practitioner - Nurse Practitioner 2961747746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Health, LLCGroup PAC ID 8628453404, 5 clinicians

Practice addresses (Care Compare)

105 Patriot St
Suite 102
Lafayette, LA 70508-6831
Phone (337) 602-8686

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP10095LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Health, LLC CurrentSince Jun 3, 2024 Accepting new patients
Calcasieu Urgent Care, LLC CurrentSince May 18, 2022 Accepting new patients
Calcasieu Urgent Care LLC CurrentSince May 18, 2022 Accepting new patients
Rosewood Rehabilitation, LLC PastSince Jun 3, 2024 Accepting new patients

Locations

4002 Jackson St
#B
Alexandria, LA 71303
Phone (337) 288-2865

1750 Elton Rd
Jennings, LA 70546
Phone (337) 329-6565

105 Patriot St
Ste 102
Lafayette, LA 70508
Phone (337) 602-8686

814 W McNeese St
Ste 100
Lake Charles, LA 70605
Phone (337) 562-3200

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

Organizations & group practices 4

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": "1540512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1558838615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122425 DEPT 2425",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122425",
            "telephone_number": "337-494-4747",
            "fax_number": "337-494-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 3RD AVE STE 110",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706010404",
            "telephone_number": "337-494-4747",
            "fax_number": "337-494-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAND",
        "first_name": "CHRISTIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-26",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP10095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.