Individual provider Active NPI

Brody James Leblanc, DO

  • Family Medicine Physician
  • Lafayette, LA
National Provider Identifier
1578058699
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T-3600 Issued in MS
Practice address
3220 Kaliste Saloom Rd
Lafayette, LA 70508-7422
Phone
(337) 470-3370
Fax
(337) 470-4402
NPI assigned
Jul 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T-3600 MS Primary

Addresses

Primary practice location

3220 Kaliste Saloom Rd
Lafayette, LA 70508-7422

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0011

Other practice location 1

2514 67th Avenue Loop Ste 112
Meridian, MS 39307-7260
Phone (601) 482-4955

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
I20210603000550 LA Practitioner - Family Practice 7911306469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lourdes Physician Group LLCGroup PAC ID 7214177757, 157 clinicians

Practice addresses (Care Compare)

4811 Ambassador Caffery Pkwy
Suite 305
Lafayette, LA 70508-7266
Phone (337) 470-3040

Hospital & facility affiliations

  • Vitalcaring Group Home health agency, Lafayette, LA, CCN 197612
  • Acadian Homecare / Abbeville Home health agency, Abbeville, LA, CCN 197769
  • Acadian Homecare, LLC Home health agency, Lafayette, LA, CCN 197060
  • Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
  • Abbeville General Hospital Hospital, Abbeville, LA, CCN 190034
  • Abrom Kaplan Memorial Hospital Hospital, Kaplan, LA, CCN 191322
  • Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-3600MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Physician Group LLC Family Medicine CurrentSince Jul 1, 2021 Accepting new patients

Locations

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

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

4811 Ambassador Caffery Pkwy
Ste 305
Lafayette, LA 70508
Phone (337) 470-3040

3220 Kaliste Saloom Rd
Lafayette, LA 70508
Phone (337) 406-9474

Interoperability endpoints

  • Direct secure messaging: brody.leblanc.1@18357.direct.athenahealth.com
  • Direct secure messaging: bleblanc74687@direct.casso.us.com

Organizations & group practices 1

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1530403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1578058699",
    "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": "225-526-0011",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 KALISTE SALOOM RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087422",
            "telephone_number": "337-470-3370",
            "fax_number": "337-470-4402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2514 67th Avenue Loop Ste 112",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393077260",
            "country_code": "US",
            "telephone_number": "601-482-4955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "BRODY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-01",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "T-3600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.