JANNA KIRSTEN FLINT WILSON (NPI# 1447325360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447325360 |
| Entity Type | Individual |
| Full Name | JANNA KIRSTEN FLINT WILSON |
| Other Name | JANNA KIRSTEN FLINT |
| Credential | MD |
| Practice Address |
4704 Ambassador Caffery Pkwy Lafayette LA 70508-6908 |
| Practice Telephone | 3373713101 |
| Practice Fax Number | 8554316867 |
| Mailing Telephone | 3373713101 |
| Mailing Fax Number | 8554316867 |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2019-02-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
MD.202173 | LA | Allopathic & Osteopathic Physicians |
| N | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
036.118014 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1175650 | 05 |
| 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 |
| 1144397472 | Deiadra Garrett | Pediatrics | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2006-11-30 |
| 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 | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| 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/certification - 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 |
|---|---|---|---|---|
| 1306071162 | Amy Arceneaux Vitte | Pediatrics | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2009-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194741355 | Victor Vincent Pouw | Pediatrics | 27350 Highway 190, Lacombe, LA 70445-6403 | 2006-07-14 |
| 1508316928 | Aqeel Alaqeel | Pediatrics | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2016-10-10 |
| 1164839361 | Mahmoud Adeeb Ah Hamdan | Pediatrics | 200 Henry Clay Ave, Children Hospital, First Floor, New Orleans, LA 70118-5720 | 2014-07-20 |
| 1700175130 | Carmen Dorina Mironovici | Pediatrics | 1514 Jefferson Hwy, New Orleans, LA 70121 | 2011-04-06 |
| 1255660338 | Cielo R Alleyn | Pediatrics | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2009-12-18 |
| 1588897094 | Bimota Nambam | Pediatrics | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2009-08-31 |
| 1184814659 | Dania L Felipe-ramirez | Pediatrics | 200 Henry Clay Ave, Children's Hospital Research Bldg, New Orleans, LA 70118-5720 | 2007-07-30 |
| 1245250265 | Sudha Reddy | Pediatrics | 1501 Kings Hwy, Department of Pediatrics, Section of Endocrinology, Shreveport, LA 71103-4228 | 2006-07-20 |
| 1497772453 | Robert Mcvie | Pediatrics | 1501 Kings Hwy, Department of Pediatrics, Section of Endocrinology, Shreveport, LA 71103-4228 | 2006-07-16 |
| 1376534131 | Chantal Salim Lutfallah | Pediatrics | 7777 Hennessy Blvd, Suite 502, Baton Rouge, LA 70808-4300 | 2005-11-02 |
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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.