Elise Fontenot Edwards, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

312926 Issued in LA

Practice address

2300 Hospital Dr Ste 120
Bossier City, LA 71111-2193

Phone

(318) 212-7982

Fax

(318) 212-7989

NPI assigned

Apr 7, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Elise Marie Fontenot Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eedwards3@direct.wkhs.com

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.

• WK Urgent Care Center-Pierremont

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1639115132

  Single Specialty

  Medicare reassignment NPD
• WK Preferred Pediatrics

  • Pediatrics Physician
  • Bossier City, LA
  • NPI 1760043491

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1780048587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR STE 120",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112193",
            "telephone_number": "318-212-7982",
            "fax_number": "318-212-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR STE 120",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112193",
            "telephone_number": "318-212-7982",
            "fax_number": "318-212-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ELISE",
        "middle_name": "FONTENOT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2021-07-06",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "312926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELISE",
            "last_name": "FONTENOT",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Willie E Eason
• Meredith N Eastin, PNP
• Stacey Wright Eaves, ACNP
• Delanna Riley Edwards
• Donna Bair Edwards, MCD, CCC-SLP
• Nada El-Baghdadi, LCSW
• Elite Pulse Transport & CPR Limited Liability Company
• Christopher Lee Ellis, DC, MS
• Megan Ellis, BCBA
• Kimberly Elmore

• Pediatrics Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.