Individual provider Active NPI

Renee Lagrange, FNP-C

  • Family Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1699473793
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
229489 Issued in LA
Practice address
120 Rue Louis Xiv BLDG 2
Lafayette, LA 70508-5739
Phone
(337) 233-6665
Fax
(337) 534-0179
NPI assigned
Feb 17, 2023
Last updated
Feb 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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 229489 LA Primary

Addresses

Primary practice location

120 Rue Louis Xiv BLDG 2
Lafayette, LA 70508-5739

Mailing address

1025 Mims LN
Breaux Bridge, LA 70517-7205
Phone (337) 962-6231

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
I20240111003855 LA Practitioner - Nurse Practitioner 3870944028 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Urology LLC CurrentSince Nov 1, 2023 Accepting new patients
Southern Urology, LLC CurrentSince Nov 1, 2023 Accepting new patients
Southern Urology LLC PastSince Nov 20, 2022 Accepting new patients

Locations

120 Rue Louis Xiv
Lafayette, LA 70508
Phone (337) 233-6665

120 Rue Louis Xiv
Bldg 1
Lafayette, LA 70508
Phone (337) 769-7779

120 Rue Louis Xiv
Bldg 2
Lafayette, LA 70508
Phone (337) 233-6665

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1699473793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MIMS LN",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705177205",
            "telephone_number": "337-962-6231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 RUE LOUIS XIV BLDG 2",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085739",
            "telephone_number": "337-233-6665",
            "fax_number": "337-534-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGRANGE",
        "first_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "229489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.