NPIMap

Individual provider Active NPI

Maureen Adrian Poe, APRN

  • Gerontology Nurse Practitioner
  • Sulphur, LA
National Provider Identifier
1992700272
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP01864 Issued in LA
Practice address
921 1St Ave
Sulphur, LA 70663-3424
Phone
(337) 526-6774
Fax
(337) 375-0021
NPI assigned
Jun 14, 2005
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP01864 LA Primary
Adult Medicine Physician 207QA0505X AP01864 LA
Geriatric Medicine (Family Medicine) Physician 207QG0300X AP01864 LA

Addresses

Primary practice location

921 1St Ave
Sulphur, LA 70663-3424

Mailing address

6464 Corbina Rd
Lake Charles, LA 70607-7674
Phone (337) 526-6774

Other practice location 1

6464 Corbina Rd
Lake Charles, LA 70607-7674
Phone (337) 526-6774

Other identifiers 1

IdentifierTypeStateIssuer
1113115MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050818000068 LA Practitioner - Nurse Practitioner 9931139193 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4045 Ernest St
Lake Charles, LA 70605-3421

6464 Corbina Rd
Lake Charles, LA 70607-7674
Phone (337) 474-7054

920 1St Ave
Sulphur, LA 70663-3425
Phone (337) 528-7472

921 1St Ave
Sulphur, LA 70663-3424
Phone (337) 527-6385

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP01864LAMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Calcasieu Cameron Hospital Service District Multi-Specialty Current Accepting new patients
Calcasieu Cameron Hospital Service District Multi-Specialty CurrentSince Jun 1, 2024 Accepting new patients
Calcasieu Cameron Hospital Service District Multi-Specialty CurrentSince Jun 1, 2024 Accepting new patients
Geriatric Resources, Inc Multi-Specialty CurrentSince Jan 1, 2003 Accepting new patients
Calcasieu Cameron Hospital Service District Multi-Specialty Past Accepting new patients

Locations

1020 Main St
Hackberry, LA 70645
Phone (337) 762-3762

501 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 312-8258

701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4270

920 1st Ave
Sulphur, LA 70663
Phone (337) 527-6301

921 1st Ave
Sulphur, LA 70663
Phone (337) 527-2491

921 1st Ave
#A
Sulphur, LA 70663
Phone (337) 439-0336

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1992700272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6464 CORBINA RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706077674",
            "telephone_number": "337-526-6774",
            "fax_number": "337-375-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 1ST AVE",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706633424",
            "telephone_number": "337-526-6774",
            "fax_number": "337-375-0021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6464 Corbina Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706077674",
            "country_code": "US",
            "telephone_number": "337-526-6774",
            "fax_number": "337-375-2001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POE",
        "first_name": "MAUREEN",
        "middle_name": "ADRIAN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "LA",
            "license": "AP01864",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "LA",
            "license": "AP01864",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "LA",
            "license": "AP01864",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1113115",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur, LA

Sources for this page

Verify at the official NPI Registry.