NPIMap

Individual provider Active NPI

Brock Jude Romero, APRN

  • Family Nurse Practitioner
  • Loreauville, LA
National Provider Identifier
1841576477
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06694 Issued in LA
Practice address
411 South Main Street
Loreauville, LA 70552
Phone
(337) 229-4214
Fax
(337) 229-4065
NPI assigned
Oct 27, 2011
Last updated
May 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

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 AP06694 LA Primary

Addresses

Primary practice location

411 South Main Street
Loreauville, LA 70552

Mailing address

411 South Main Street
P.O. Box 278
Loreauville, LA 70552
Phone (337) 229-4214

Other identifiers 1

IdentifierTypeStateIssuer
2177149MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111128000055 LA Practitioner - Nurse Practitioner 7911171152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

411 S Main St
Loreauville, LA 70552-2164
Phone (337) 229-8288

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP06694LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
James R Romero MD a Medical Corporation PastSince Mar 29, 2014 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Iberia Medical CenterNew Iberia, LA, CCN 190054 Hospital Corporate Director Apr 20, 2017
Iberia Medical CenterNew Iberia, LA, CCN 19S054 Hospital Corporate Director Apr 20, 2017
Iberia Medical CenterNew Iberia, LA, CCN 19T054 Hospital Corporate Director Apr 20, 2017
Jeanerette Rural Health ClinicJeanerette, LA, CCN 193404 Rural health clinic Corporate Director Apr 20, 2017
Rural Health Clinic of LoreauvilleLoreauville, LA, CCN 193833 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee (100%)		 Sep 23, 2013
Sep 23, 2013

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 4

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": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1841576477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 SOUTH MAIN STREET",
            "address_2": "P.O. BOX 278",
            "city": "LOREAUVILLE",
            "state": "LA",
            "postal_code": "70552",
            "telephone_number": "337-229-4214",
            "fax_number": "337-229-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 SOUTH MAIN STREET",
            "city": "LOREAUVILLE",
            "state": "LA",
            "postal_code": "70552",
            "telephone_number": "337-229-4214",
            "fax_number": "337-229-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "BROCK",
        "middle_name": "JUDE",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-27",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2177149",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loreauville, LA

Sources for this page

Verify at the official NPI Registry.