EXOTIC EXPRESSIONS INC. (NPI# 1295272623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295272623 |
| Entity Type | Organization |
| Organization Name | EXOTIC EXPRESSIONS INC. |
| Other Organization Name | SHANA MADALYN WILTZ |
| Practice Address |
729 Cecile Blvd Breaux Bridge LA 70517-5707 |
| Mailing Address |
729 Cecile Blvd Bldg A- 1 Breaux Bridge LA 70517-5707 |
| Practice Telephone | 3373760473 |
| Mailing Telephone | 3373760473 |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |
| Authorized Official Name | MRS. SHANA MADALYN WILTZ (CEO) |
| Authorized Official Telephone | 3373760473 |
| Authorized Official Credential | LICENSED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302F00000X | Exclusive Provider Organization | 11041986 | LA | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| SHANA MADALYN WILTZ | Former Legal Business Name - Organization |
| Street Address |
729 CECILE BLVD |
| City | BREAUX BRIDGE |
| State | LA |
| Zip Code | 70517-5707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811528789 | Celesta Bertrand Johnson | Nurse Practitioner | 1038 School Rd, Cecilia, LA 70517 | 2020-01-30 |
| 1265077804 | Kevin Labry | Physical Medicine & Rehabilitation | 1220 Berard St., Breaux Bridge, LA 70517 | 2019-11-07 |
| 1700398153 | Carmanlita Sampson | Case Manager/Care Coordinator | 1117 Saltmine Hwy, Breaux Bridge, LA 70517 | 2017-10-25 |
| 1457870297 | Denita Marie Derouselle | Case Manager/Care Coordinator | 251 Rees St, Breaux Bridge, LA 70517 | 2017-09-13 |
| 1831645191 | Breaux Bridge Mm LLC | Clinic/Center | 1451 E Bridge Street, Breaux Bridge, LA 70517 | 2016-08-28 |
| 1215395975 | Hoa Nguyen | Pharmacist | 1401 Rees Street, Breaux Bridge, LA 70517 | 2016-02-09 |
| 1407213960 | Tracy Senegal | Counselor | 241 Anderson St, Breaux Bridge, LA 70517 | 2016-01-27 |
| 1396138145 | Community Healthcare Clinic, LLC | Nurse Practitioner | 1421 Henderson Highway, Henderson, LA 70517 | 2015-03-17 |
| 1386989358 | Brittney Alexander Sanders | Nurse Practitioner | 1021 School Street, Breaux Bridge, LA 70517 | 2012-12-03 |
| 1437400967 | Lourdes After Hours LLC - Breaux Bridge | Clinic/Center | 1821 Rees St, Breaux Bridge, LA 70517 | 2012-09-24 |
| Find all providers in zip 70517 | ||||
| Taxonomy Code | 302F00000X |
| Grouping | Managed Care Organizations |
| Classification | Exclusive Provider Organization |
| (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 15; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58; (3) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
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| 1689128712 | Early Behavioral Interventions | Exclusive Provider Organization | 1224 N Parkerson Ave, Crowley, LA 70526-3614 | 2016-08-05 |
| 1609329937 | Kiyoshi Washington | Exclusive Provider Organization | 4911 Desire Dr, New Orleans, LA 70126-3535 | 2016-08-03 |
| 1902263643 | The Lighthouse Community Care | Exclusive Provider Organization | 120 Rusty Lane, Houma, LA 70360-0120 | 2016-01-26 |
| 1174991186 | Agape Center for Troubled Youth | Exclusive Provider Organization | 2013 Macarthur Dr, Bldg 2, Alexandria, LA 71301-3720 | 2015-09-08 |
| 1447626064 | Divinthe Training and Consulting Services, LLC | Exclusive Provider Organization | 623 Franklin Ave, Gretna, LA 70053-2115 | 2015-08-18 |
| 1821481714 | Therapeutic Behavioral Servicess | Exclusive Provider Organization | 605 Silver Lilly Ln, Marrero, LA 70072-1426 | 2015-03-17 |
| 1932520442 | Eye of The Storm Ministries Incorporated | Exclusive Provider Organization | 29 Highway 454, Pineville, LA 71360 | 2013-12-31 |
| 1699010595 | Precious Moments Quality Care, LLC | Exclusive Provider Organization | 508 Laran St, Ville Platte, LA 70586-3737 | 2012-12-03 |
| 1861701153 | Norman L. Dykes, Md, Apmc | Exclusive Provider Organization | 105 Sheridan Dr, Lafayette, LA 70506-2609 | 2010-10-04 |
| 1356655260 | Ky Chiropractic, L.L.C. | Exclusive Provider Organization | 2926 Canal St, Suite A, New Orleans, LA 70119-6304 | 2010-08-03 |
| Find all providers with the same taxonomy | ||||
| City | BREAUX BRIDGE |
| Zip Code | 70517 |
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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.