Individual provider Active NPI

Maggie Marie Fontenot, FNP-C

  • Family Nurse Practitioner
  • Eunice, LA
National Provider Identifier
1629893045
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202627 Issued in LA
Practice address
3256 Highway 190
Eunice, LA 70535-5125
Phone
(337) 550-8530
Fax
(337) 550-8534
NPI assigned
Nov 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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 202627 LA Primary

Addresses

Primary practice location

3256 Highway 190
Eunice, LA 70535-5125

Mailing address

604 N Acadia Rd Ste 101
Thibodaux, LA 70301-4897
Phone (985) 446-5079

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
I20241202001024 LA Practitioner - Nurse Practitioner 5890220743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Louisiana Ear, Nose, and Throat Specialists, Inc.Group PAC ID 0042313504, 65 clinicians

Practice addresses (Care Compare)

1890 W Gauthier Rd
Suite 150
Lake Charles, LA 70605-7119
Phone (337) 480-5559

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202627LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Ear, Nose, & Throat Specialists, Inc. CurrentSince Nov 21, 2024 Accepting new patients

Locations

3256 Highway 190
Eunice, LA 70535
Phone (337) 550-3740

1636 Elton Rd
Ste 205
Jennings, LA 70546
Phone (337) 580-7500

1700 Kaliste Saloom Rd
Ste 100
Lafayette, LA 70508
Phone (337) 210-2098

1890 W Gauthier Rd
Ste 150
Lake Charles, LA 70605
Phone (337) 480-5559

604 N Acadia Rd
Ste 101
Thibodaux, LA 70301
Phone (985) 446-5079

1635 Carter St
Vidalia, LA 71373

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.

NPI Registry JSON

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

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1629893045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N ACADIA RD STE 101",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014897",
            "telephone_number": "985-446-5079",
            "fax_number": "985-447-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3256 HIGHWAY 190",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705355125",
            "telephone_number": "337-550-8530",
            "fax_number": "337-550-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "MAGGIE",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-20",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "202627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eunice, LA

Sources for this page

Verify at the official NPI Registry.