NPIMap

Organization Active NPI

Kenneth J. Champagne, M.D., Apmc

  • Colon & Rectal Surgery Physician
  • Lafayette, LA
National Provider Identifier
1912967316
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
017238 Issued in LA
Legal business name
KENNETH J. CHAMPAGNE, M.D., APMC
Practice address
102 Drury LN
Lafayette, LA 70508-5702
Phone
(337) 233-0219
Fax
(337) 233-2418
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Authorized official

Name
Ms. Sondra A. Bernard, RHIA
Title
Office Manager
Phone
(337) 233-0219

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208C00000X 017238 LA Primary

Addresses

Primary practice location

102 Drury LN
Lafayette, LA 70508-5702

Mailing address

102 Drury LN
Lafayette, LA 70508-5702
Phone (372) 233-0219

Other identifiers 2

IdentifierTypeStateIssuer
DG9731OtherLAREILROAD MEDICARE
1396681MedicaidLA

Other names 1

  • COLON AND RECTAL CLINIC OF ACADIANA Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1912967316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 DRURY LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085702",
            "telephone_number": "372-233-0219",
            "fax_number": "337-233-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DRURY LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085702",
            "telephone_number": "337-233-0219",
            "fax_number": "337-233-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH J. CHAMPAGNE, M.D., APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "BERNARD",
        "authorized_official_first_name": "SONDRA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "337-233-0219",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RHIA"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "LA",
            "license": "017238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REILROAD MEDICARE",
            "identifier": "DG9731",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396681",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLON AND RECTAL CLINIC OF ACADIANA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "COLON AND RECTAL CLINIC OF ACADIANA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.