Organization Active NPI

Audubon Family Medicine LLC

  • Family Medicine Physician
  • Lafayette, LA
National Provider Identifier
1568060135
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AUDUBON FAMILY MEDICINE LLC
Practice address
2301 Moss St
Lafayette, LA 70501-2125
Phone
(504) 220-5733
NPI assigned
Oct 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Authorized official

Name
Brandi Nunez Washington, FNPNPI 1831613553
Title
Family Nurse Practitioner
Phone
(504) 220-5733

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2301 Moss St
Lafayette, LA 70501-2125

Mailing address

11268 Waverly Dr
New Orleans, LA 70128-3417
Phone (504) 220-5733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201124000158 LA Part B Supplier - Clinic/Group Practice 0446661441 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2215844Audubon Family Medicine2301 Moss Street, Lafayette, LA 70501Certificate of waiverMar 7, 2027

National Provider Directory

National Provider Directory

Locations

2301 Moss St
Lafayette, LA 70501
Phone (337) 706-7400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1568060135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11268 WAVERLY DR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701283417",
            "telephone_number": "504-220-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 MOSS ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705012125",
            "telephone_number": "504-220-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDUBON FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_middle_name": "NUNEZ",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "504-220-5733",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.