Individual provider Active NPI

Angela Renee Fontenot, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1770056301
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202446 Issued in LA
Practice address
901 Hugh Wallis Rd S
Lafayette, LA 70508
Phone
(337) 250-2000
NPI assigned
Jan 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 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 202446 LA Primary

Addresses

Primary practice location

901 Hugh Wallis Rd S
Lafayette, LA 70508

Mailing address

196 Wild Iris Dr
Evangeline, LA 70537-3203
Phone (337) 250-2000

Other practice location 1

1322 Elton Rd Ste G
Jennings, LA 70546-4100
Phone (337) 616-3482

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
I20190405000974 LA Practitioner - Nurse Practitioner 3971656190 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
202446LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Shadows of Jennings, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1770056301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 WILD IRIS DR",
            "city": "EVANGELINE",
            "state": "LA",
            "postal_code": "705373203",
            "telephone_number": "337-250-2000",
            "fax_number": "337-616-9399"
        },
        {
            "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": "70508",
            "telephone_number": "337-250-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1322 Elton Rd Ste G",
            "address_purpose": "LOCATION",
            "city": "Jennings",
            "state": "LA",
            "postal_code": "705464100",
            "country_code": "US",
            "telephone_number": "337-616-3482",
            "fax_number": "337-616-9399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "ANGELA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "202446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.