Individual provider Active NPI

Elizabeth Marie Landry, FNP-C

  • Family Nurse Practitioner
  • Leesville, LA
National Provider Identifier
1750101275
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
237623 Issued in LA
Practice address
1201 W Fertitta Blvd
Leesville, LA 71446-4637
Phone
(337) 392-9438
NPI assigned
Oct 10, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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 237623 LA Primary

Addresses

Primary practice location

1201 W Fertitta Blvd
Leesville, LA 71446-4637

Mailing address

1201 W Fertitta Blvd
Leesville, LA 71446-4637
Phone (337) 392-9438

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
I20250131002821 LA Practitioner - Nurse Practitioner 9234668450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
CLHG-LeesvilleGroup PAC ID 4082963301, 25 clinicians
Physical Therapy Services of West Louisiana IncGroup PAC ID 0446388763, 92 clinicians

Practice addresses (Care Compare)

1020 W Fertita Blvd
Leesville, LA 71446-4645
Phone (318) 239-9041

1201 W Fertitta Blvd
West Louisiana Family Practice Leesville
Leesville, LA 71446-4637
Phone (337) 392-9438

301 W Fertitta Blvd
Suite 4
Leesville, LA 71446-4665
Phone (337) 238-9931

427 N Pine St
Byrd Walk in Clinic
Deridder, LA 70634-3905
Phone (337) 462-6471

Hospital & facility affiliations

  • Elara Caring Home health agency, Leesville, LA, CCN 197260
  • Byrd Regional Hospital Hospital, Leesville, LA, CCN 190164
  • Beauregard Memorial Hospital Hospital, Deridder, LA, CCN 190050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CLHG-Leesville CurrentSince Nov 21, 2024 Accepting new patients
CLHG-Leesville CurrentSince Nov 21, 2024 Accepting new patients
CLHG-Leesville Current Accepting new patients
Byrd Medical Clinic Inc Past Accepting new patients

Locations

427 N Pine St
Deridder, LA 70634
Phone (337) 239-0989

1201 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 238-0620

506 S 6th St
Leesville, LA 71446
Phone (337) 239-0989

301 W Fertitta Blvd
Ste 1
Leesville, LA 71446
Phone (337) 238-0167

1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278

Interoperability endpoints

  • Direct secure messaging: elizabeth.landry.1@17837.direct.athenahealth.com

Organizations & group practices 5

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.

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": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1750101275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W FERTITTA BLVD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464637",
            "telephone_number": "337-392-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W FERTITTA BLVD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464637",
            "telephone_number": "337-392-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "237623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.