Individual provider Active NPI

Ekara N Wafer-Mendenhall

  • Nurse Practitioner
  • Homer, LA
National Provider Identifier
1811304074
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP07981 Issued in LA
Practice address
611 W 2ND St
Homer, LA 71040-3221
Phone
(318) 265-4542
Fax
(318) 550-4271
NPI assigned
Jul 18, 2014
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP07981 LA Primary
Family Nurse Practitioner 363LF0000X RN125342 LA

Addresses

Primary practice location

611 W 2ND St
Homer, LA 71040-3221

Mailing address

611 W 2ND St
Homer, LA 71040-3221
Phone (318) 265-4542

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
I20150506000216 LA Practitioner - Nurse Practitioner 3971822305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

611 W 2ND St
Homer, LA 71040-3221
Phone (318) 265-4542

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP07981LAMDNurse Practitioner
RN125342LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Divinity Healthcare Services Family CurrentSince Jun 2, 2024 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Aug 1, 2023 Accepting new patients

Locations

611 W 2nd St
Homer, LA 71040
Phone (318) 265-4542

201 Saint Charles Ave
Ste 2500
New Orleans, LA 70170
Phone (504) 224-6402

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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 6

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": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1811304074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W 2ND ST",
            "city": "HOMER",
            "state": "LA",
            "postal_code": "710403221",
            "telephone_number": "318-265-4542",
            "fax_number": "318-550-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W 2ND ST",
            "city": "HOMER",
            "state": "LA",
            "postal_code": "710403221",
            "telephone_number": "318-265-4542",
            "fax_number": "318-550-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAFER-MENDENHALL",
        "first_name": "EKARA",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP07981",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN125342",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer, LA

Sources for this page

Verify at the official NPI Registry.