Organization Active NPI

Maternal Fetal Medicine of Acadiana

  • Maternal & Fetal Medicine Physician
  • Lafayette, LA
National Provider Identifier
1770587248
Registry record updated Oct 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
11220R Issued in LA
Legal business name
MATERNAL FETAL MEDICINE OF ACADIANA
Practice address
105 Corporate Blvd
Lafayette, LA 70508-3850
Phone
(337) 593-9099
Fax
(337) 948-4392
NPI assigned
Jun 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2008

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

Authorized official

Name
Paul K. Dibbs, M.D.
Title
Owner
Phone
(337) 942-1151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VM0101X 11220R LA Primary

Addresses

Primary practice location

105 Corporate Blvd
Lafayette, LA 70508-3850

Mailing address

PO Box 51742
Lafayette, LA 70505-1742
Phone (337) 593-9099

Other identifiers 1

IdentifierTypeStateIssuer
1447757MedicaidLA

National Provider Directory

National Provider Directory

Locations

3975 I 49 S Service Rd
Ste 205A
Opelousas, LA 70570
Phone (337) 942-1151

1270 Attakapas Dr
Ste 501
Opelousas, LA 70570
Phone (337) 942-1151

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1770587248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51742",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051742",
            "telephone_number": "337-593-9099",
            "fax_number": "337-948-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083850",
            "telephone_number": "337-593-9099",
            "fax_number": "337-948-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATERNAL FETAL MEDICINE OF ACADIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-11",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "DIBBS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-942-1151",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "LA",
            "license": "11220R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447757",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; 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.