TED ETELL FONTENOT (NPI# 1598052052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598052052 |
| Entity Type | Individual |
| Full Name | TED ETELL FONTENOT |
| Other Name | ETELL JOSEPH FONTENOT |
| Credential | ANP |
| Practice Address |
1717 Oak Park Blvd Second Floor Lake Charles LA 70601-8991 |
| Practice Telephone | 3374943278 |
| Practice Fax Number | 3374943240 |
| Mailing Telephone | 3374943278 |
| Mailing Fax Number | 3374943240 |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2012-03-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP06448 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2159445 | 05 |
| Street Address |
1717 OAK PARK BLVD SECOND FLOOR |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70601-8991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013910801 | William R Condos Jr. | Internal Medicine | 1717 Oak Park Blvd, Fl 2, Lake Charles, LA 70601-8990 | 2005-05-24 |
| 1467821629 | Courtney Clark | Nurse Practitioner | 1717 Oak Park Blvd, Lake Charles, LA 70601-8991 | 2015-09-17 |
| 1568845899 | Kathy Parker Woodward | Nurse Practitioner | 1717 Oak Park Blvd, 3rd Floor, Lake Charles, LA 70601-8991 | 2015-07-06 |
| 1356730303 | Rikki Monticello | Nurse Practitioner | 1717 Oak Park Blvd, 3rd Floor, Lake Charles, LA 70601-8991 | 2015-01-14 |
| 1831507961 | Rebecca Kindler | Optometrist | 1717 Oak Park Blvd, Ste 1, Lake Charles, LA 70601-8991 | 2014-08-01 |
| 1588007249 | Martin Daniel Castillo | Nurse Practitioner | 1717 Oak Park Blvd, 3rd Fl, Lake Charles, LA 70601-8991 | 2013-04-12 |
| 1043553522 | Amanda Joiner Saltzman | Pharmacist | 1717 Oak Park Blvd, Suite 110, Lake Charles, LA 70601-8991 | 2013-04-03 |
| 1932450210 | Keysha Raye Nabours | Nurse Practitioner | 1717 Oak Park Blvd, 2nd Fl, Lake Charles, LA 70601-8991 | 2012-09-26 |
| 1063778504 | Margaret Young Carter | Ophthalmology | 1717 Oak Park Blvd, #1, Lake Charles, LA 70601-8991 | 2012-04-10 |
| 1215161922 | Lcms Rehabilitation Institute of Southwest Louisiana | Internal Medicine | 1717 Oak Park Blvd, 3rd Floor, Lake Charles, LA 70601-8991 | 2009-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833872 | Fresenius Medical Care Sulphur, LLC | Clinic/Center | 330 Chavanne Street, Lake Charles, LA 70601 | 2020-08-24 |
| 1174158844 | Andrea Cormier | Peer Specialist | 751 E Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2020-03-03 |
| 1588297303 | Vivian Claire Miller Monceaux | Chiropractor | 780 Bayou Pines East Drive, Lake Charles, LA 70601 | 2020-02-20 |
| 1568001014 | Swla Center for Health Services | Clinic/Center | 3820 Senator J. Bennett Johnston Ave, Charleston Bldg 8, Lake Charles, LA 70601 | 2020-01-02 |
| 1417512070 | Ryan Nathaniel Vaisler | Student in an Organized Health Care Education/Training Program | 1525 Oak Park Blvd., Lake Charles, LA 70601 | 2019-05-08 |
| 1336600675 | Hoh Palliative Care, LLC | Family Medicine | 750 East Bayou Pines, Suite A, Lake Charles, LA 70601 | 2019-03-28 |
| 1073079026 | Alawrass LLC | Pharmacy | 803 E Prien Lake Rd, Lake Charles, LA 70601 | 2019-02-14 |
| 1861962722 | Ellaweena Woods | Counselor | 1409 Kirkman St., Lake Charles, LA 70601 | 2018-12-04 |
| 1770051963 | Hanna Marie Rodriguez | Counselor | 751 Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2018-11-06 |
| 1023585213 | Shandora Druilhet | Case Manager/Care Coordinator | 751 E Bayou Pines, Lake Charles, LA 70601 | 2018-10-26 |
| Find all providers in zip 70601 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154747186 | Dennis W. Kleinpeter | Nurse Practitioner | 503 W Sallier St, Lake Charles, LA 70601-5756 | 2014-03-14 |
| 1629377239 | Hinton Np Services, LLC | Nurse Practitioner | 2822 Henderson Forest Dr, Lake Charles, LA 70605-2259 | 2011-03-22 |
| 1437390721 | Dawn Marie Hinton | Nurse Practitioner | 4150 Nelson Rd Ste A3, Lake Charles, LA 70605-4169 | 2009-03-16 |
| 1689774259 | Mary Jane Mckinnie | Nurse Practitioner | 905 11th St, Lake Charles, LA 70601-6230 | 2006-09-24 |
| 1164403630 | Anna Marie Crawford | Nurse Practitioner | 555 S Ryan St, 101, Lake Charles, LA 70601-5724 | 2005-11-10 |
| 1235492778 | Jennifer Taylor Graham | Nurse Practitioner | 2770 3rd Ave # S350, Lake Charles, LA 70601-8994 | 2012-06-20 |
| 1962763714 | Morgan Rae Gilmore | Nurse Practitioner | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2012-06-07 |
| 1174800569 | Hollie Steffens Donnelly | Nurse Practitioner | 2802 Pineview St, Lake Charles, LA 70615-2063 | 2011-11-14 |
| 1083994347 | Carolyn Rideaux | Nurse Practitioner | 2837 Ernest St, Lake Charles, LA 70601-8785 | 2011-08-18 |
| 1275811572 | Karie J Savoy | Nurse Practitioner | 2770 3rd Ave Ste 350, Lake Charles, LA 70601-0404 | 2011-08-03 |
| Find all providers in LAKE CHARLES | ||||
| City | LAKE CHARLES |
| Zip Code | 70601 |
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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.