Individual provider Active NPI

Dara Alyse Bearb, APRN-CNP

  • Pediatric Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1740986975
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
229390 Issued in LA
Practice address
2903 1St Ave
Lake Charles, LA 70601-8809
Phone
(337) 478-6480
Fax
(337) 474-9637
NPI assigned
Jan 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 229390 LA Primary

Addresses

Primary practice location

2903 1St Ave
Lake Charles, LA 70601-8809

Mailing address

2903 1St Ave
Lake Charles, LA 70601-8809
Phone (337) 478-6480

Other identifiers 1

IdentifierTypeStateIssuer
229390OtherLALSBN, APRN-CNP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
229390LAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1740986975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 1ST AVE",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018809",
            "telephone_number": "337-478-6480",
            "fax_number": "337-474-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2903 1ST AVE",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018809",
            "telephone_number": "337-478-6480",
            "fax_number": "337-474-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARB",
        "first_name": "DARA",
        "middle_name": "ALYSE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "229390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LSBN, APRN-CNP",
            "identifier": "229390",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.