Deidre L Stelly MD Apmllc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DEIDRE L STELLY MD APMLLC

Practice address

112 Champagne Blvd
Breaux Bridge, LA 70517-3852

Phone

(337) 261-5151

NPI assigned

Oct 6, 2005

Last updated

Mar 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deidre L Stelly, MD

Title

Owner

Phone

(337) 261-5151

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alan P. Broussard, MD

  • Family Medicine Physician
  • Breaux Bridge, LA
  • NPI 1700874468
  NPD (past)
• Jeanne Dauphine Theriot, M.D.

  • Family Medicine Physician
  • Breaux Bridge, LA
  • NPI 1093763625
  NPD (past)

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1902894637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 CHAMPAGNE BLVD",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173852",
            "telephone_number": "337-332-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 CHAMPAGNE BLVD",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173852",
            "telephone_number": "337-261-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEIDRE L STELLY MD APMLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "STELLY",
        "authorized_official_first_name": "DEIDRE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-261-5151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1443077",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deaundra Thomas Davis, RAC
• Francheska Davis
• Joshua Davis
• Benjamin Thomas Degatur, M.D.
• Warren J. Degatur Jr., M.D.
• Acea Demouchet
• Denita Marie Derouselle
• Edward Avery Doerle, P.T.
• Lynne Duay, M.A. CCC-SLP
• Natalie Marea Duff, LCSW, BACS

• Family Medicine Physician in Breaux Bridge, LA
• Providers in Breaux Bridge, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.