Eryn Ezell, NCPT

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

1072852 Issued in LA

Practice address

106 Heymann Blvd
Lafayette, LA 70503-2322

Phone

(337) 504-4279

Fax

(337) 504-4692

NPI assigned

Jul 9, 2020

Last updated

Jul 9, 2020By 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 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1568080166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 HEYMANN BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032322",
            "telephone_number": "337-504-4279",
            "fax_number": "337-504-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 HEYMANN BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032322",
            "telephone_number": "337-504-4279",
            "fax_number": "337-504-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZELL",
        "first_name": "ERYN",
        "credential": "NCPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "LA",
            "license": "1072852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCT",
            "identifier": "1072852",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eryn.frederick@merakey.org",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "106 Heymann Blvd",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705032322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Eye Care South, LLC
• Eyemart Express LLC
• Eyemart Express LTD (Eyewear Express)
• Jenna Eymard
• Rachel Ezulike, PHARMD
• Philip Jules Fabacher, MD
• Jeffrey Faber, PT
• Fabian Lugo MD, a Professional Medical Corporation
• Tracy Fabre, CRNA

• Phlebology Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Phlebology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.