Individual provider Active NPI

Laterica Lasha Antoine, FNP

  • Family Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1609422724
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
206958 Issued in LA
Practice address
441 Heymann Blvd
Lafayette, LA 70503-2611
Phone
(337) 289-8429
Fax
(337) 289-8431
NPI assigned
Aug 14, 2019
Last updated
Apr 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 206958 LA Primary

Addresses

Primary practice location

441 Heymann Blvd
Lafayette, LA 70503-2611

Mailing address

441 Heymann Blvd
Lafayette, LA 70503-2611
Phone (337) 289-8429

Other names 1

  • Laterica Lasha Sanders Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190927001018 LA Practitioner - Nurse Practitioner 2860722246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Institute of the South, LLCGroup PAC ID 3779497441, 145 clinicians

Practice addresses (Care Compare)

2390 W Congress St
Lafayette, LA 70506-4205
Phone (337) 261-6000

441 Heymann Blvd
Lafayette, LA 70503-2611
Phone (337) 289-8429

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
206958LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital & Clinics, Inc. CurrentSince Apr 1, 2020 Accepting new patients
University Hospital & Clinics Inc CurrentSince Apr 1, 2020 Accepting new patients
Kenneth L Entes MD Apmc PastSince Aug 18, 2019 Accepting new patients

Locations

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

Interoperability endpoints

  • Direct secure messaging: lsanders1446378@direct.ochsner.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1609422724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 HEYMANN BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032611",
            "telephone_number": "337-289-8429",
            "fax_number": "337-289-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 HEYMANN BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032611",
            "telephone_number": "337-289-8429",
            "fax_number": "337-289-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOINE",
        "first_name": "LATERICA",
        "middle_name": "LASHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "206958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATERICA",
            "last_name": "SANDERS",
            "middle_name": "LASHA",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.