Acadia Total Health LLC
Organization Active NPI Internal Medicine Physician · Crowley, LA
NPI 1770075434 · NPPES record last updated Feb 14, 2019
Key facts
- NPI
- 1770075434
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 112572 (LA)
- Legal business name
- ACADIA TOTAL HEALTH LLC
- Practice address
- 1307 Crowley Rayne Hwy Ste E
Crowley, LA 70526 - Phone
- (337) 210-4045
- Fax
- (337) 210-4047
- NPI assigned
- May 30, 2018
- Organization subpart
- No
Authorized official
- Name
- Taylor Valdetero, APRN
- Title
- Managing Member
- Phone
- (337) 210-4045
Practitioners 3
-
Krislyn R Lacaze, FNP-C
-
Patrick Dale Leleux Jr., M.D.
-
Taylor Valdetero, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 19D2149680 | Acadia Total Health | Certificate of waiver | Mar 6, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180626000413 | LA | Part B Supplier - Clinic/Group Practice | 7517212921 |
Receives reassigned benefits from 3 practitioners Practice locations: Crowley, LA |
National Provider Directory
Locations
1307 Crowley Rayne Hwy
Ste E
Crowley, LA 70526
Phone (337) 210-4045
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 112572 | LA | Yes |
Addresses
Primary practice location
1307 Crowley Rayne Hwy Ste E
Crowley, LA 70526
Mailing address
1307 Crowley Rayne Hwy Ste E
Crowley, LA 70526-8210
Phone (337) 210-4045
Other providers in Crowley, LA
- Acadia General Hospital, Inc.
- Acadia General Hospital, Inc.
- Acadia Laboratory LLC
- Acadia Parish School System
- Acadia Parish School System
- Acadia Women'S Health
- Acadia Wound Care and Hyperbarics
- Acadian Diabetes Self Management LLC
- Acadiana After Hours, LLC
- Acadiana Area Human Services District
All providers in Crowley, LA · Internal Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.