ANGELIQUE BLAIR CARMOUCHE (NPI# 1396307476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396307476 |
| Entity Type | Individual |
| Full Name | ANGELIQUE BLAIR CARMOUCHE |
| Credential | MAT, LAT,ATC |
| Practice Address |
Lsu Athletic Administration Building Baton Rouge LA 70803-0001 |
| Practice Telephone | 2255788001 |
| Mailing Telephone | 2255788001 |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2019-06-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083S0010X |
Preventive Medicine Specialization: Sports Medicine |
319966 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
LSU ATHLETIC ADMINISTRATION BUILDING |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70803-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851709216 | Derek Calvert | Specialist/Technologist | Lsu Athletic Administration Building, Athletic Training Room, Baton Rouge, LA 70803 | 2014-07-30 |
| 1922667641 | Hannah Roudebush | Physical Medicine & Rehabilitation | Lsu Athletic Administration Building, Baton Rouge, LA 70803-0001 | 2019-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649822164 | Joshua Vaughn Bunch | Specialist/Technologist | Lsu Athletic Department, Athletic Training, North Stadium Drive, Baton Rouge, LA 70803 | 2019-07-15 |
| 1225512767 | Louisiana State University | Pharmacy | 1 North Stadium Drive, Broussard Center for Athletic Training, Baton Rouge, LA 70803 | 2018-09-20 |
| 1447652433 | Joshua Pratt | Specialist/Technologist | Lsu Athletic Training, Athletic Administration Building, Baton Rouge, LA 70803 | 2014-09-22 |
| 1770924599 | Malena Badon | Clinical Medical Laboratory | 340 East Parker Street, Baton Rouge, LA 70803 | 2013-07-09 |
| 1649394057 | Cheryl Larrieu Bourg | Pharmacist | Lsu Student Health Center Pharmacy, Infirmary Road, Lsu, Baton Rouge, LA 70803 | 2007-03-19 |
| 1548369465 | Louisiana State Univ Students Health Ctr | Pharmacist | Infirmary Road, Room 172 Pharmacy, Baton Rouge, LA 70803 | 2006-09-21 |
| 1912937145 | Louisiana Emergency & Trauma Specialists | Emergency Medicine | 3600 Florida Blvd, Baton Rouge, LA 70803 | 2006-07-04 |
| 1295373025 | Jacqueline Casey Crouch | Student in an Organized Health Care Education/Training Program | North Stadium Drive Athletics Administration Building, Baton Rouge, LA 70803-0001 | 2019-12-11 |
| 1013552512 | Kelly Stephens | Specialist/Technologist | 1 North Stadium Dr, Baton Rouge, LA 70803-0001 | 2019-11-08 |
| 1962062729 | Maria Berthiaume | Physical Medicine & Rehabilitation | Lsu Broussard Center for Athletic Training, Baton Rouge, LA 70803-0001 | 2019-06-14 |
| Find all providers in zip 70803 | ||||
| Taxonomy Code | 2083S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Sports Medicine |
| A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598243412 | Brooke Lynn Boggs | Preventive Medicine | 800 North Hazel St., Hammond, LA 70401 | 2018-08-02 |
| 1154546802 | Max Travis Mahaffey | Preventive Medicine | 3347 Masonic Dr, Alexandria, LA 71301-3842 | 2007-04-16 |
| City | BATON ROUGE |
| Zip Code | 70803 |
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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.