Individual provider Active NPI

Taylor James Rene Belaire, FNP

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1730773524
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
218663 Issued in LA
Practice address
2750 Aster St
Lake Charles, LA 70601-8824
Phone
(337) 480-8900
Fax
(337) 480-8901
NPI assigned
Feb 23, 2021
Last updated
Jan 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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 218663 LA Primary

Addresses

Primary practice location

2750 Aster St
Lake Charles, LA 70601-8824

Mailing address

PO Box 122539 Dept 2539
Dallas, TX 75312-0001
Phone (337) 494-2772

Other identifiers 2

IdentifierTypeStateIssuer
2563050MedicaidLA
218663OtherLASTATE NP LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address intmed@mmg.imed.phimailbox.com Direct

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
I20210622000960 LA Practitioner - Nurse Practitioner 9335540848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2750 Aster St
Lake Charles, LA 70601-8824
Phone (337) 480-8900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Charles Medical Services Family Practice Associates, LLC CurrentSince Mar 1, 2023 Accepting new patients

Locations

1890 W Gauthier Rd
Ste 155
Lake Charles, LA 70605
Phone (337) 477-6061

217 Sam Houston Jones Pkwy
Ste 104
Lake Charles, LA 70611
Phone (337) 480-8989

2750 Aster St
Lake Charles, LA 70601
Phone (337) 478-2650

Interoperability endpoints

  • Direct secure messaging: intmed@mmg.imed.phimailbox.com
  • Direct secure messaging: tbelaire5281968@direct.casso.us.com

Organizations & group practices 1

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 4

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": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1730773524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122539 DEPT 2539",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753120001",
            "telephone_number": "337-494-2772",
            "fax_number": "337-494-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 ASTER ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018824",
            "telephone_number": "337-480-8900",
            "fax_number": "337-480-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELAIRE",
        "first_name": "TAYLOR",
        "middle_name": "JAMES RENE",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-23",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "218663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2563050",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE NP LICENSE",
            "identifier": "218663",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "intmed@mmg.imed.phimailbox.com",
            "affiliation": "N",
            "endpointDescription": "direct email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2770 3rd Ave Ste 350",
            "city": "Lake Charles",
            "state": "LA",
            "country_code": "US",
            "postal_code": "706010404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.