NPIMap

Organization Active NPI

Dwayne J Bergeaux MD Nephrology & Hypertension

  • Nephrology Physician
  • Crowley, LA
National Provider Identifier
1669229647
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
DWAYNE J BERGEAUX MD NEPHROLOGY & HYPERTENSION
Practice address
1325 Wright Ave Ste B
Crowley, LA 70526-2226
Phone
(337) 788-2864
Fax
(337) 788-2866
NPI assigned
May 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Kelly Bergeaux
Title
Office Manager
Phone
(337) 788-2864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1325 Wright Ave Ste B
Crowley, LA 70526-2226

Mailing address

1325 Wright Ave Ste B
Crowley, LA 70526-2226
Phone (337) 788-2864

Other practice location 1

1902 Johnson St
Jennings, LA 70546-3628
Phone (337) 788-2864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241101000291 LA Part B Supplier - Clinic/Group Practice 9133652944 Receives reassigned benefits from 1 practitioner
Practice locations: Crowley, LA; Jennings, LA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: clinic@bergeaux.imed.phimailbox.com

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1669229647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 WRIGHT AVE STE B",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705262226",
            "telephone_number": "337-788-2864",
            "fax_number": "337-788-2866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 WRIGHT AVE STE B",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705262226",
            "telephone_number": "337-788-2864",
            "fax_number": "337-788-2866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1902 Johnson St",
            "address_purpose": "LOCATION",
            "city": "Jennings",
            "state": "LA",
            "postal_code": "705463628",
            "country_code": "US",
            "telephone_number": "337-788-2864",
            "fax_number": "337-788-2866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DWAYNE J BERGEAUX MD NEPHROLOGY & HYPERTENSION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "BERGEAUX",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "337-788-2864"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crowley, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.