Individual provider Active NPI

Charles Eugene Padgett Jr., MD

  • Obstetrics & Gynecology Physician
  • Lafayette, LA
National Provider Identifier
1770102931
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
339526 Issued in LA
Practice address
435 Heymann Blvd
Lafayette, LA 70503-2616
Phone
(337) 234-3344
NPI assigned
Apr 8, 2020
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 339526 LA Primary

Addresses

Primary practice location

435 Heymann Blvd
Lafayette, LA 70503-2616

Mailing address

435 Heymann Blvd
Lafayette, LA 70503-2616

Other practice location 1

625 19th St S
Birmingham, AL 35233-1900
Phone (205) 996-3130

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240502002684 LA Practitioner - Obstetrics/Gynecology 3971943291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Louisiana State University School of Medicine in Shreveport, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daniel R. Bourque, M.D., a.P.M.C.Group PAC ID 5092907220, 3 clinicians

Practice addresses (Care Compare)

435 Heymann Blvd
Lafayette, LA 70503-2616
Phone (337) 234-3344

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
339526LAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel R. Bourque, M.D., a.P.M.C. Obstetrics & Gynecology CurrentSince Mar 26, 2024 Accepting new patients

Locations

435 Heymann Blvd
Lafayette, LA 70503
Phone (337) 234-3344

Interoperability endpoints

  • Direct secure messaging: cpadgett5292756@direct.casso.us.com
  • FHIR API: https://fhir.healthtogo.me/fhir/r4/imed.bourque

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1770102931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 HEYMANN BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 HEYMANN BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032616",
            "telephone_number": "337-234-3344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-996-3130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADGETT",
        "first_name": "CHARLES",
        "middle_name": "EUGENE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "339526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.