Active NPI
Philip Jules Fabacher, MD
- Cardiovascular Disease Physician
- Lafayette, LA
National Provider Identifier
1922029941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 17821
- Practice address
- Lsu Central Clinic
2390 West Congress Street
Lafayette, LA 70506 - Phone
- (337) 261-6580
- NPI assigned
- Jul 23, 2006
- 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 17821 | LA | Primary |
Addresses
Primary practice location
Lsu Central Clinic
2390 West Congress Street
Lafayette, LA 70506
Mailing address
1340 Poydras St
New Orleans, LA 70112-1221
Phone (504) 412-1860
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1344320 | Medicaid | LA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17821 | LA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lsuhn Billing LLC | Past | Accepting new patients | |
| Lsuhn Billing LLC | Past | Accepting new patients |
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.
-
- Oral and Maxillofacial Surgery (Dentist)
- Baton Rouge, LA
- NPI 1306247556
-
- Multi-Specialty Clinic/Center
- Lafayette, LA
- NPI 1992975775
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922029941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 POYDRAS ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701121221",
"telephone_number": "504-412-1860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LSU CENTRAL CLINIC",
"address_2": "2390 WEST CONGRESS STREET",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "70506",
"telephone_number": "337-261-6580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABACHER",
"first_name": "PHILIP",
"middle_name": "JULES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "LA",
"license": "17821",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1344320",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.