Individual provider Active NPI

Brendalee Constant, FNP-BC/AGACNP-BC

  • Nurse Practitioner
  • Thibodaux, LA
National Provider Identifier
1881315224
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
227268 Issued in LA
Practice address
602 N Acadia Rd
Thibodaux, LA 70301-4823
Phone
(985) 447-5500
NPI assigned
Sep 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 227268 LA Primary

Addresses

Primary practice location

602 N Acadia Rd
Thibodaux, LA 70301-4823

Mailing address

602 N Acadia Rd
Thibodaux, LA 70301-4823
Phone (985) 447-5500

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
I20230221002510 LA Practitioner - Certified Clinical Nurse Specialist (CNS) 6002288081 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227268LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodaux Emergency Physicians Group LLC CurrentSince Oct 15, 2022 Accepting new patients
Physician Practice Partners Nurse Practitioner CurrentSince Aug 5, 2024 Accepting new patients

Locations

8120 Main St
Ste 203
Houma, LA 70360
Phone (985) 868-9960

8166 Main St
Houma, LA 70360
Phone (800) 456-9121

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

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.

NPI Registry JSON

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1881315224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 N ACADIA RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014823",
            "telephone_number": "985-447-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N ACADIA RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014823",
            "telephone_number": "985-447-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANT",
        "first_name": "BRENDALEE",
        "credential": "FNP-BC/AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "227268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.