Organization Active NPI

Maraist Foot and Ankle Center LLC

  • Podiatrist
  • Lafayette, LA
National Provider Identifier
1952812455
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DPM.200012 Issued in LA
Legal business name
MARAIST FOOT AND ANKLE CENTER LLC
Practice address
185 S Beadle Rd # B2
Lafayette, LA 70508-4287
Phone
(337) 234-0384
Fax
(337) 761-6021
NPI assigned
Oct 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Kelli Duhon
Title
Administrator
Phone
(337) 280-6298

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X DPM.200012 LA Primary

Addresses

Primary practice location

185 S Beadle Rd # B2
Lafayette, LA 70508-4287

Mailing address

185 S Beadle Rd # B2
Lafayette, LA 70508-4287
Phone (337) 234-0384

Other identifiers 1

IdentifierTypeStateIssuer
1150100MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clinic@maraistfoot.imed.phimailbox.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180109000077 LA Part B Supplier - Clinic/Group Practice 1850650367 Receives reassigned benefits from 1 practitioner
Practice locations: Lafayette, LA
O20180516001367 LA DME Supplier - Physician - Podiatry 1850650367 Practice locations: Lafayette, LA

National Provider Directory

National Provider Directory

Locations

185 S Beadle Rd
#B2
Lafayette, LA 70508
Phone (337) 234-0384

185 S Beadle Rd
Ste B2
Lafayette, LA 70508
Phone (337) 234-0384

Interoperability endpoints

  • Direct secure messaging: clinic@maraistfoot.imed.phimailbox.com

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1952812455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 S BEADLE RD # B2",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705084287",
            "telephone_number": "337-234-0384",
            "fax_number": "337-761-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S BEADLE RD # B2",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705084287",
            "telephone_number": "337-234-0384",
            "fax_number": "337-761-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARAIST FOOT AND ANKLE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "DUHON",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "337-280-6298"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "LA",
            "license": "DPM.200012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1150100",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clinic@maraistfoot.imed.phimailbox.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "185 S BEADLE RD #B2",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.