NPIMap

Organization Active NPI

Lafayette Health Ventures, Inc

Doing business as Cancer Center Of Acadiana at Lafayette General

  • Hematology & Oncology Physician
  • Lafayette, LA
National Provider Identifier
1972835130
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
LAFAYETTE HEALTH VENTURES, INC
Doing business as
Cancer Center Of Acadiana at Lafayette General
Practice address
1211 Coolidge Blvd
Suite 101
Lafayette, LA 70503
Phone
(337) 289-8044
Fax
(337) 289-8401
NPI assigned
Feb 12, 2010
Last updated
Jun 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Authorized official

Name
Kim Dooley
Title
Coo
Phone
(337) 571-1394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NU Primary

Addresses

Primary practice location

1211 Coolidge Blvd
Suite 101
Lafayette, LA 70503

Mailing address

PO Box 53092
Lafayette, LA 70505-3092
Phone (337) 289-8933

Other identifiers 2

IdentifierTypeStateIssuer
2115103MedicaidLA
CG2600OtherLARAILROAD MEDICARE

Other names 1

  • Cancer Center Of Acadiana at Lafayette General Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041105000263 LA Part B Supplier - Clinic/Group Practice 9335043074 Receives reassigned benefits from 428 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lafayette HLTH Ventures in24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

1211 Coolidge Blvd
Ste 101
Lafayette, LA 70503
Phone (337) 289-8044

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1972835130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53092",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705053092",
            "telephone_number": "337-289-8933",
            "fax_number": "337-289-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 COOLIDGE BLVD",
            "address_2": "SUITE 101",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70503",
            "telephone_number": "337-289-8044",
            "fax_number": "337-289-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE HEALTH VENTURES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-12",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "DOOLEY",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "337-571-1394"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2115103",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG2600",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cancer Center Of Acadiana at Lafayette General",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cancer Center Of Acadiana at Lafayette General",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 21, 2023; 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.