Individual provider Active NPI

Tiameko Rochelle Overton, NP

  • Women's Health Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1962492249
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP04787 Issued in LA
Practice address
105 Corporate Blvd
Lafayette, LA 70508-3850
Phone
(337) 593-9099
Fax
(337) 769-8509
NPI assigned
Oct 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP04787 LA Primary

Addresses

Primary practice location

105 Corporate Blvd
Lafayette, LA 70508-3850

Mailing address

PO Box 51742
Lafayette, LA 70505-1742
Phone (337) 593-9099

Other identifiers 1

IdentifierTypeStateIssuer
1630420MedicaidLA

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
I20051101000667 LA Practitioner - Nurse Practitioner 4789601444 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Women First, LLC CurrentSince Aug 7, 2020 Accepting new patients
Iberia Comprehensive Community Health Center,Inc. Past Accepting new patients

Locations

2309 Old Jeanerette Rd
New Iberia, LA 70563
Phone (337) 256-5317

Interoperability endpoints

  • Direct secure messaging: tiameko.overton@icchc.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1962492249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51742",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051742",
            "telephone_number": "337-593-9099",
            "fax_number": "337-769-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083850",
            "telephone_number": "337-593-9099",
            "fax_number": "337-769-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERTON",
        "first_name": "TIAMEKO",
        "middle_name": "ROCHELLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "LA",
            "license": "AP04787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1630420",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.