DEIADRA GARRETT (NPI# 1144397472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144397472 |
| Entity Type | Individual |
| Full Name | DEIADRA GARRETT |
| Credential | MD |
| Practice Address |
4704 Ambassador Caffery Pkwy Lafayette LA 70508-6908 |
| Practice Telephone | 3373713101 |
| Practice Fax Number | 3373713160 |
| Mailing Telephone | 3373713101 |
| Mailing Fax Number | 3373713160 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2019-02-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 02974 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036114195 1 | 05 | |
| IL | BCBS PROVIDER ID | 1627123 | 01 |
| Street Address |
4704 AMBASSADOR CAFFERY PKWY |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-6908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427080738 | Kenneth W Falterman | Surgery | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2006-07-07 |
| 1124673439 | David Paul Bailey | Physician Assistant | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2019-08-04 |
| 1144673344 | Janci Bienvenu Detwiler | Nurse Practitioner | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2016-07-22 |
| 1780009613 | Sarah Iblings | Nurse Practitioner | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2014-03-01 |
| 1669715322 | Ryan Patrick Farmer | Orthopaedic Surgery | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508 | 2013-04-01 |
| 1568788479 | Kenneth Richmond Habetz | Psychiatry & Neurology | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2010-04-16 |
| 1306071162 | Amy Arceneaux Vitte | Pediatrics | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2009-05-22 |
| 1487844650 | Gabriel L Dersam | Orthopaedic Surgery | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2007-07-25 |
| 1447325360 | Janna Kirsten Flint Wilson | Pediatrics | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2006-11-24 |
| 1407878929 | Leslie Gauthier Fontenot | Dietitian, Registered | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2006-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1184250607 | Learning Grove Therapy LLC | Clinic/Center | 105 Anaheim Lane, Lafayette, LA 70508 | 2020-03-16 |
| 1780218727 | Jennifer Trumps | Case Manager/Care Coordinator | 200 Entergy Parkway, Lafayette, LA 70508 | 2020-02-28 |
| 1740749605 | Hunter Sy Arceneaux | Physical Therapist | 1700 Kaliste Saloom Road, Building 3, Suite 300, Lafayette, LA 70508 | 2019-03-19 |
| 1295292787 | Brad Michael Gros | Counselor | 160 South Beadle Road, Lafayette, LA 70508 | 2019-02-21 |
| 1205337581 | Alternative Perspectives, LLC | Clinic/Center | 2807 Kaliste Saloom Rd Ste B, Lafayette, LA 70508 | 2018-02-22 |
| 1124528807 | Zachariah James Hebert | Counselor | 1602 W Pinhook Rd Suite 100a, The Family Tree, Lafayette, LA 70508 | 2018-02-19 |
| 1164934477 | Ilyas Munshi, Md Apmc | Non-Pharmacy Dispensing Site | 99 W. Martial Ave, Lafayette, LA 70508 | 2017-10-26 |
| 1447761226 | Louisiana Orthopaedic Specialists, LLC | Durable Medical Equipment & Medical Supplies | 4231 Ambassador Caffery Pkwy, Suite 102, Lafayette, LA 70508 | 2017-10-19 |
| 1306365457 | Mk Dixon Counseling and Consulting | Counselor | 105 Industrial Parkway, Lafayette, LA 70508 | 2017-09-10 |
| Find all providers in zip 70508 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093170433 | Southcare Medical LLC | Pediatrics | 110 Curran Ln, Lafayette, LA 70506 | 2015-12-30 |
| 1639425523 | Deepa Vasireddy | Pediatrics | 7053 Johnston St, Lafayette, LA 70503-6305 | 2012-07-27 |
| 1215293147 | Mark Leclerc | Pediatrics | 3 Rimrock Rd, Lafayette, CA 94549-4924 | 2012-04-04 |
| 1578854196 | Geneva Marie Guidry Lejeune | Pediatrics | 200 Beaullieu Dr Ste 7, Lafayette, LA 70508-7230 | 2011-04-30 |
| 1174835631 | Durga P Naidu | Pediatrics | 4630 Ambassador Caffery Pkwy Ste 404, Lafayette, LA 70508-6951 | 2010-07-12 |
| 1427236108 | Children's Multi-specialty Group LLC | Pediatrics | 4704 Ambassador Caffery Parkway, Lafayette, LA 70508 | 2008-02-05 |
| 1841477726 | Diane Kramer Gordon | Pediatrics | 500 Patterson St, Lafayette, LA 70501-1849 | 2008-01-23 |
| 1477748861 | Lafayette Childrens Clinic LLC | Pediatrics | 5000 Ambassador Caffery Pkwy., # 12, Lafayette, LA 70508 | 2007-09-10 |
| 1639362650 | Kristine Falcon Chimento | Pediatrics | 107 Montrose Ave Ste D, Lafayette, LA 70503-3852 | 2007-08-22 |
| 1659577302 | Katherine Alexis Lindle | Pediatrics | 1460 S College Rd, Lafayette, LA 70503 | 2007-06-21 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.