Individual provider Active NPI

Mia Hebert Rabalais

  • Family Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1730475344
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06575 Issued in LA
Practice address
901 Hugh Wallis Rd S
Lafayette, LA 70508-2511
Phone
(337) 233-1307
NPI assigned
Jun 22, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 AP06575 LA Primary

Addresses

Primary practice location

901 Hugh Wallis Rd S
Lafayette, LA 70508-2511

Mailing address

112 La Villa Cir
Youngsville, LA 70592-5548
Phone (337) 207-3756

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
I20111101000525 LA Practitioner - Nurse Practitioner 8325211675 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

901 Hugh Wallis Rd S
BLDG B
Lafayette, LA 70508-2511
Phone (337) 447-4371

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
LHCG Ccxiii, LLC Nurse Practitioner CurrentSince Dec 1, 2021 Accepting new patients
LHCG Lxxvi LLC Nurse Practitioner CurrentSince Aug 30, 2020 Accepting new patients
Hynson Bayou Inpatient Services LLC Past Accepting new patients
Hospitalist Medicine Physicians of Rapides Parish, LLC Past Accepting new patients

Locations

6501 Coliseum Blvd
Ste 700F
Alexandria, LA 71303
Phone (318) 319-2246

901 Hugh Wallis Rd S
Lafayette, LA 70508
Phone (337) 262-9319

901 Hugh Wallis Rd S
Bldg B
Lafayette, LA 70508

426 Heather Dr
Opelousas, LA 70570
Phone (337) 447-4371

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730475344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LA VILLA CIR",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925548",
            "telephone_number": "337-207-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 HUGH WALLIS RD S",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705082511",
            "telephone_number": "337-233-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABALAIS",
        "first_name": "MIA",
        "middle_name": "HEBERT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.