Individual provider Active NPI

Charlotte G. Merrill, APRN, DNP, FNP-C,

  • Family Nurse Practitioner
  • Pineville, LA
National Provider Identifier
1982988515
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06656 Issued in LA
Practice address
2809 Donahue Ferry Rd
Pineville, LA 71360-4513
Phone
(318) 704-6568
Fax
(318) 704-6572
NPI assigned
Sep 30, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP06656 LA Primary

Addresses

Primary practice location

2809 Donahue Ferry Rd
Pineville, LA 71360-4513

Mailing address

16 N Lake Dr
Woodworth, LA 71485-9511
Phone (318) 704-6568

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
I20131121000602 LA Practitioner - Nurse Practitioner 7113167560 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agilus Health, Inc CurrentSince Apr 1, 2018 Accepting new patients

Locations

1305 Texas Ave
Alexandria, LA 71301
Phone (318) 443-5278

Organizations & group practices 1

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": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1982988515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 N LAKE DR",
            "city": "WOODWORTH",
            "state": "LA",
            "postal_code": "714859511",
            "telephone_number": "318-704-6568",
            "fax_number": "318-704-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 DONAHUE FERRY RD",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604513",
            "telephone_number": "318-704-6568",
            "fax_number": "318-704-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "CHARLOTTE",
        "middle_name": "G.",
        "name_prefix": "Mrs.",
        "credential": "APRN, DNP, FNP-C,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-30",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, LA

Sources for this page

Verify at the official NPI Registry.