Individual provider Active NPI

Chelsea Rene' Petrolia, APRN

  • Family Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1821535006
Registry record updated Oct 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP09142 Issued in LA
Practice address
1700 Kaliste Saloom Rd BLDG 1
Lafayette, LA 70508-6186
Phone
(337) 354-6285
NPI assigned
Jan 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2017

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 AP09142 LA Primary

Addresses

Primary practice location

1700 Kaliste Saloom Rd BLDG 1
Lafayette, LA 70508-6186

Mailing address

1700 Kaliste Saloom Rd
Lafayette, LA 70508-6186

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
I20170810001268 LA Practitioner - Nurse Practitioner 6608147533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Urology LLCGroup PAC ID 5597833772, 27 clinicians

Practice addresses (Care Compare)

120 Rue Louis Xiv
Lafayette, LA 70508-5739
Phone (337) 600-1678

1926 S Union St
Opelousas, LA 70570-5725
Phone (337) 594-4025

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.2 of 100Reported as group
Promoting interoperability
92
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP09142LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Urology, LLC CurrentSince Jul 2, 2018 Accepting new patients
Southern Urology LLC CurrentSince Jul 2, 2018 Accepting new patients
Louisiana Ear, Nose, & Throat Specialists, Inc. Past Accepting new patients
Hebert Medical Group, Apmc Past Accepting new patients

Locations

120 Rue Louis Xiv
Bldg 2
Lafayette, LA 70508
Phone (337) 233-6665

120 Rue Louis Xiv
Lafayette, LA 70508
Phone (337) 233-6665

Organizations & group practices 4

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 5

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": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509235200000",
    "number": "1821535006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 KALISTE SALOOM RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 KALISTE SALOOM RD BLDG 1",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086186",
            "telephone_number": "337-354-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROLIA",
        "first_name": "CHELSEA",
        "middle_name": "RENE'",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.