Acadia Dermatology and Aesthetic Center, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

201271 Issued in LA

Legal business name

ACADIA DERMATOLOGY AND AESTHETIC CENTER, LLC

Practice address

404 N Acadia Rd
Thibodaux, LA 70301-4856

Phone

(985) 447-3889

NPI assigned

Jan 11, 2017

Last updated

Jan 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gretchen LandryNPI 1851913412

Title

Practice Administrator

Phone

(985) 447-3889

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

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

CLIA laboratory certificates

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.

• Kyle M Coleman, MD

  • Dermatology Physician
  • Thibodaux, LA
  • NPI 1588777361

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Sara Cook Stone, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Thibodaux, LA
  • NPI 1063669521
  Medicare reassignment Care Compare group
• Gretchen Landry, LCSW

  • Clinical Social Worker
  • Thibodaux, LA
  • NPI 1851913412
  NPD Authorized official

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

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484092800000",
    "number": "1568908770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 N ACADIA RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014856",
            "telephone_number": "985-447-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N ACADIA RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014856",
            "telephone_number": "985-447-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADIA DERMATOLOGY AND AESTHETIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-11",
        "last_updated": "2017-01-11",
        "status": "A",
        "authorized_official_last_name": "LANDRY",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "985-447-3889"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "201271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 2ND Chance Counseling
• Jamarcus J Aaron, BAASC
• Sabrina Absher
• Abundant Health Medical Clinic, LLC (Abundant Health Medical Clinic)
• Acadia Family Dentistry
• Acadian Chiroprctic and Rehab LLC
• Access Health Louisiana
• Accurate Eye Care LLC
• Clel Louis Acosta, MD

• Dermatology Physician in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.