DR. KENNETH W FALTERMAN (NPI# 1427080738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427080738 |
Entity Type | Individual |
Full Name | DR. KENNETH W FALTERMAN |
Credential | MD |
Practice Address |
4704 Ambassador Caffery Pkwy Lafayette LA 70508-6908 |
Mailing Address |
Po Box 81932 Lafayette LA 70598-1932 |
Practice Telephone | 3373713101 |
Practice Fax Number | 3373713160 |
Mailing Telephone | 3379832468 |
Mailing Fax Number | 3379832471 |
Enumeration Date | 2006-07-07 |
Last Update Date | 2019-02-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
011745 | LA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
LA | 1195197 | 05 |
Street Address |
4704 AMBASSADOR CAFFERY PKWY |
City | LAFAYETTE |
State | LA |
Zip Code | 70508-6908 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
1144397472 | Deiadra Garrett | Pediatrics | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2006-11-30 |
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 |
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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 |
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Taxonomy Code | 2086S0120X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Pediatric Surgery |
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114957172 | Pediatric General Surgery Apmc | Surgery | 4650 Ambassador Caffery Pkwy, Ste 202, Lafayette, LA 70508-6926 | 2006-07-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285251884 | A'drianne Dorsey | Surgery | 2742 S Roth Ave, Gonzales, LA 70737-4823 | 2020-06-30 |
1518923317 | John B Lopoo Jr. | Surgery | 8200 Constantin Blvd Ste 220, Baton Rouge, LA 70809-3481 | 2006-04-21 |
1689672172 | Donald Lynn Sorrells Jr. | Surgery | 2508 Bert Kouns Industrial Loop, Shreveport, LA 71118-3133 | 2005-07-08 |
1316386436 | Wk Pediatric Surgical Associates | Surgery | 2508 Bert Kouns Loop, Shreveport, LA 71118-3133 | 2013-06-21 |
1386943579 | Jessica Aya Zagory | Surgery | 1542 Tulane Ave, Rm 734a, New Orleans, LA 70112-2865 | 2011-03-28 |
1720247364 | Fabienne Lee Gray | Surgery | 200 Henry Clay Ave, Office of Pediatric Surgery, New Orleans, LA 70118 | 2008-06-09 |
1487863627 | Shawn J Stafford | Surgery | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2007-05-22 |
1548309156 | Pediatric Surgery of Louisiana, LLC | Surgery | 7777 Hennessy Blvd, Suite 212, Baton Rouge, LA 70808 | 2007-02-06 |
1902975543 | Benjamin B. Peeler | Surgery | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2006-11-07 |
1801976238 | Mary Brandt | Surgery | 200 Henry Clay Ave, New Orleans, LA 70118-5798 | 2006-10-17 |
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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.