Individual provider Active NPI

Chantel Charpentier, FNP-C

  • Family Nurse Practitioner
  • Thibodaux, LA
National Provider Identifier
1821086133
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP03960 Issued in LA
Practice address
931 N Canal Blvd
Thibodaux, LA 70301-8095
Phone
(985) 446-6381
Fax
(985) 446-5992
NPI assigned
Oct 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP03960 LA Primary

Addresses

Primary practice location

931 N Canal Blvd
Thibodaux, LA 70301-8095

Mailing address

931 N Canal Blvd
Thibodaux, LA 70301-8095
Phone (985) 446-6381

Other identifiers 1

IdentifierTypeStateIssuer
1141844MedicaidLA

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
I20040825000538 LA Practitioner - Nurse Practitioner 4486628302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raja Talluri MD a Professional Medical CorporationGroup PAC ID 6608817077, 4 clinicians

Practice addresses (Care Compare)

931 N Canal Blvd
Thibodaux Medical Clinic
Thibodaux, LA 70301-8095
Phone (985) 446-6381

Hospital & facility affiliations

  • Thibodaux Regional Medical Center Hospital, Thibodaux, LA, CCN 190004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Raja Talluri MD a Professional Medical Corporation CurrentSince Oct 1, 2012 Accepting new patients
Checkups - la LLC Nurse Practitioner Past Accepting new patients

Locations

931 N Canal Blvd
Thibodaux, LA 70301
Phone (985) 446-6381

22080 Highway 20
Vacherie, LA 70090
Phone (225) 265-3061

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 and National Provider Directory roles.

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1821086133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 N CANAL BLVD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703018095",
            "telephone_number": "985-446-6381",
            "fax_number": "985-446-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 N CANAL BLVD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703018095",
            "telephone_number": "985-446-6381",
            "fax_number": "985-446-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARPENTIER",
        "first_name": "CHANTEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP03960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1141844",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.