Individual provider Active NPI

Eunice Elizabeth Neeley, MD, MPH

  • Student in an Organized Health Care Education/Training Program
  • Lafayette, LA
National Provider Identifier
1578980686
Registry record updated Sep 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3149 Ambassador Caffery Pkwy
Lafayette, LA 70506-7209
Phone
(337) 706-3415
NPI assigned
Mar 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 337586 LA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3149 Ambassador Caffery Pkwy
Lafayette, LA 70506-7209

Mailing address

3149 Ambassador Caffery Pkwy
Lafayette, LA 70506-7209
Phone (337) 706-3415

Other practice location 1

116 Broad St
San Francisco, CA 94112-2925
Phone (510) 978-0213

Other practice location 2

4500 N Shallowford Rd Ste B
Atlanta, GA 30338
Phone (440) 778-6920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170926004253 GA Order and Referring Only - Family PracticePractitioner - Family Practice 6204100449
I20210419000558 GA Order and Referring Only - Preventive MedicinePractitioner - Preventive Medicine 6204100449

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
337586LAMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694217600000",
    "number": "1578980686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3149 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705067209",
            "telephone_number": "337-706-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3149 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705067209",
            "telephone_number": "337-706-3415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 Broad St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941122925",
            "country_code": "US",
            "telephone_number": "510-978-0213",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4500 N Shallowford Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30338",
            "country_code": "US",
            "telephone_number": "440-778-6920",
            "fax_number": "440-778-6901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEELEY",
        "first_name": "EUNICE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2023-09-09",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "LA",
            "license": "337586",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.