NPIMap

Individual provider Active NPI

Paul E Fenn Jr., M.D.

  • Orthopaedic Foot and Ankle Surgery Physician
  • Lafayette, LA
National Provider Identifier
1720006687
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
MD.200825 Issued in LA
Practice address
105 Patriot Ave
Suite 101
Lafayette, LA 70508
Phone
(337) 534-0653
Fax
(337) 534-0658
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Harvard Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Reconstructive Sub-Specialists LLC 2 clinicians
Hawkeye Medical, LLC 33 clinicians
CLHG-Avoyelles LLC 39 clinicians

Practice addresses (Care Compare)

105 Patriot St
Lafayette, LA 70508-6831

4231 Hwy 1192
Marksville, LA 71351-4711
Phone (318) 240-6000

5541 Hwy 1
Marksville, LA 71351-2650
Phone (318) 240-7240

Hospital & facility affiliations

  • Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
  • Lafayette Surgical Specialty Hospital Hospital, Lafayette, LA, CCN 190259
  • Avoyelles Hospital Hospital, Marksville, LA, CCN 190099

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)17
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061018000107 LA Practitioner - Orthopedic Surgery 2365473014 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200825LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CLHG-Avoyelles LLC CurrentSince Jan 22, 2024 Accepting new patients
Hawkeye Medical, LLC CurrentSince Apr 9, 2024 Accepting new patients
CLHG-Avoyelles LLC CurrentSince Jan 22, 2024 Accepting new patients
Orthopaedic and Sports Medicine Specialist Past Accepting new patients
Orthopaedic Reconstructive Sub-Specialists, LLC PastSince Aug 18, 2008 Accepting new patients
NPI 1861410300 Orthopaedic Surgery Past Accepting new patients

Locations

301 4th St
Ste 30139
Alexandria, LA 71301
Phone (318) 443-9191

4231 Highway 1192
Marksville, LA 71351
Phone (318) 240-6000

4239 Highway 1192
Ste 300
Marksville, LA 71351
Phone (318) 253-0677

5541 Highway 1
Marksville, LA 71351
Phone (318) 240-7240

Interoperability endpoints

  • Direct secure messaging: paul.fenn.1@30808.direct.athenahealth.com
  • Direct secure messaging: paul.fenn.1@16696.direct.athenahealth.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X MD.200825 LA Primary

Addresses

NPPES NPI Registry

Primary practice location

105 Patriot Ave
Suite 101
Lafayette, LA 70508

Mailing address

105 Patriot Ave
Suite 101
Lafayette, LA 70508-8520
Phone (337) 534-0653

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 7, 2018.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1720006687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PATRIOT AVE",
            "address_2": "SUITE 101",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705088520",
            "telephone_number": "337-534-0653",
            "fax_number": "337-534-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PATRIOT AVE",
            "address_2": "SUITE 101",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "337-534-0653",
            "fax_number": "337-534-0658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENN",
        "first_name": "PAUL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "LA",
            "license": "MD.200825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.