Individual provider Active NPI

Amanda M Perrodin, FNP (APRN)

  • Family Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1891073292
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN112617-AP06555 Issued in LA
Practice address
427 Heymann Blvd
Lafayette, LA 70503-2616
Phone
(337) 234-1111
NPI assigned
Aug 2, 2011
Last updated
Oct 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 RN112617-AP06555 LA Primary

Addresses

Primary practice location

427 Heymann Blvd
Lafayette, LA 70503-2616

Mailing address

427 Heymann Blvd
Lafayette, LA 70503-2616
Phone (337) 234-1111

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
I20110901000066 LA Practitioner - Nurse Practitioner 1153591011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2390 W Congress St
Lafayette, LA 70506-4205
Phone (337) 261-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN112617-AP06555LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital & Clinics, Inc. CurrentSince Sep 26, 2022 Accepting new patients
University Hospital & Clinics Inc CurrentSince Sep 26, 2022 Accepting new patients

Locations

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

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 3

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": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1891073292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 HEYMANN BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032616",
            "telephone_number": "337-234-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 HEYMANN BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032616",
            "telephone_number": "337-234-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRODIN",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "FNP (APRN)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN112617-AP06555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.