Andrea Kaleena George, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA200803 Issued in LA

Practice address

4811 Ambassador Caffery Pkwy Ste 305
Lafayette, LA 70508-7266

Phone

(337) 470-3040

Fax

(337) 470-3052

NPI assigned

Mar 20, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1426809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1679967368",
    "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": "225-526-0010",
            "fax_number": "225-765-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 AMBASSADOR CAFFERY PKWY STE 305",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087266",
            "telephone_number": "337-470-3040",
            "fax_number": "337-470-3052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3330 Masonic Dr",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713013841",
            "country_code": "US",
            "telephone_number": "318-448-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "ANDREA",
        "middle_name": "KALEENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-20",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA200803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2502498",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genoa Healthcare LLC
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• Geoffrey a. Mire, MD Inc
• George Jude Bares MD Apmc
• Amelia George, LPC
• Danielle Nicole George
• Johnetta M George
• Shawana George
• Valen George
• Gerald L Nickerson Jr MD Apmc

• Physician Assistant in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.