Tamela L Marca Charbonnet MD/Lee H Grafton MD

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

023735 Issued in LA

Legal business name

TAMELA L MARCA CHARBONNET MD/LEE H GRAFTON MD

Practice address

Grafton Derm and Cosmetic Surgery
327 Bayou Gardens Blvd
Houma, LA 70360

Phone

(985) 876-5000

Fax

(985) 876-5280

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Ann Bourgedis

Title

Office Manager

Phone

(985) 876-5000

Specialties & licenses 1

Addresses

Other identifiers 4

Tax ID family

Grafton Dermatology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Grafton Dermatology

  • Non-Pharmacy Dispensing Site
  • Houma, LA
  • NPI 1710063391
  NPD tax ID

Locations

Practitioners 2

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

• Monique B Blanchard, P.A.

  • Medical Physician Assistant
  • Houma, LA
  • NPI 1649277047
  NPD (past)
• Lee Hoye Grafton, M.D.

  • Dermatology Physician
  • Houma, LA
  • NPI 1700881141
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962501726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GRAFTON DERM AND COSMETIC SURGERY",
            "address_2": "327 BAYOU GARDENS BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GRAFTON DERM AND COSMETIC SURGERY",
            "address_2": "327 BAYOU GARDENS BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-876-5000",
            "fax_number": "985-876-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMELA L MARCA CHARBONNET MD/LEE H GRAFTON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOURGEDIS",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "985-876-5000"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "LA",
            "license": "023735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1932412",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1687421",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1441953",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1484768",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Thien Ta, OD
• Thomas A Tabor, CRNA
• Comfort Mfobefu Takang, MD, MPH
• Everette Louis Talbot, FNP-C
• Rhonda C Tamberella, CRNA
• Trayon Tanner, LCSW
• William Tanner
• Vivian Tarver
• Tasc Health Services LLC
• Brent C Tatford, MD

• Non-Pharmacy Dispensing Site in Houma, LA
• Providers in Houma, LA by specialty
• Non-Pharmacy Dispensing Site in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.