Active NPI
Paul Ananda Pati
- Family Nurse Practitioner
- Destrehan, LA
National Provider Identifier
1881369445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 221847
- Practice address
- 12589 Airline Hwy
Destrehan, LA 70047-2501 - Phone
- (985) 764-1158
- NPI assigned
- Aug 14, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 221847 | LA | Primary |
Addresses
Primary practice location
12589 Airline Hwy
Destrehan, LA 70047-2501
Mailing address
1611 Lake Ave
Metairie, LA 70005-1413
Phone (504) 421-3718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636329600000",
"number": "1881369445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 LAKE AVE",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700051413",
"telephone_number": "504-421-3718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12589 AIRLINE HWY",
"city": "DESTREHAN",
"state": "LA",
"postal_code": "700472501",
"telephone_number": "985-764-1158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATI",
"first_name": "PAUL",
"middle_name": "ANANDA",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-14",
"last_updated": "2021-11-08",
"certification_date": "2021-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "221847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Destrehan, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.