Bradley Paul Champagne, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

206155 Issued in LA

Practice address

102 Drury LN
Lafayette, LA 70508-5702

Phone

(337) 233-0219

Fax

(337) 233-2418

NPI assigned

Jun 10, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Specialty

Colorectal Surgery (Proctology)Also: General Surgery

Education

Louisiana State University School of Medicine in Shreveport, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lourdes Physician Group LLCGroup PAC ID 7214177757, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lourdes Physician Group LLC

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1437405883
  Medicare reassignment Care Compare group NPD
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  NPD (past)

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

• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  Care Compare affiliation

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1578858288",
    "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": "337-233-0219",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DRURY LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085702",
            "telephone_number": "337-233-0219",
            "fax_number": "337-233-2418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1514 Jefferson Hwy",
            "address_2": "BH 634",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701212429",
            "country_code": "US",
            "telephone_number": "504-842-3260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMPAGNE",
        "first_name": "BRADLEY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "LA",
            "license": "206155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "600535AI32",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2147846",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "INTERN",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makayla Grace Chalacoff, PA-C
• Gay G Chalpin, LCSW
• Eduardo M Chamah, M.D.
• David B Chambers, DDS
• Julie M Chambers, LPC
• Jacob Anthony Champagne, FNP-C
• Jessica Champagne, FNP
• Kenneth J. Champagne, M.D.
• Lindsey Quinn Champagne, DPT
• Chance to Change Supportive Services of Louisiana Inc

• Colon & Rectal Surgery Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Colon & Rectal Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.