DEREK FONTENOT (NPI# 1609311927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609311927 |
| Entity Type | Individual |
| Full Name | DEREK FONTENOT |
| Practice Address |
2011 Ryan St Lake Charles LA 70601-7313 |
| Mailing Address |
1531 Country Club Rd Apt 511 Lake Charles LA 70605-5343 |
| Practice Telephone | 3375083864 |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2016-12-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PST.021842 | LA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | LOUISIANA BOARD OF PHARMACY | PST.021842 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598138521 | Derek Fontenot | Physical Therapist | 240 E Laurel Ave, Eunice, LA 70535-3418 | 2015-11-13 |
| Street Address |
2011 RYAN ST |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70601-7313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780055301 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 2011 Ryan St, Lake Charles, LA 70601-7313 | 2015-10-08 |
| 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 | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407308034 | Madeline Landry | Pharmacist | 3731 Inwood Dr, Lake Charles, LA 70605-6770 | 2016-10-31 |
| 1376099143 | Jessica Pete | Pharmacist | 2818 Barb Ln, Lake Charles, LA 70607-7645 | 2016-08-31 |
| 1225498306 | Raven Rachelle Miranda | Pharmacist | 6031 Nelson Rd, Lake Charles, LA 70605-0468 | 2016-03-02 |
| 1386018661 | Joseph Tchani | Pharmacist | 1605 Whispering Woods Dr, Lake Charles, LA 70605-1300 | 2015-11-24 |
| 1861878803 | Chelsey Trammell | Pharmacist | 2000 Gerstner Memorial Dr, Lake Charles, LA 70601 | 2015-07-31 |
| 1801299037 | Howard Bosely | Pharmacist | 899 Hwy 171 North, Lake Charles, LA 70611 | 2014-10-02 |
| 1417356544 | Scott Labiche | Pharmacist | 3415 Highway 14, Lake Charles, LA 70607-2147 | 2014-08-14 |
| 1023417151 | Kyle Gardner | Pharmacist | 2500 North Highway 171, Lake Charles, LA 70601 | 2014-08-14 |
| 1598188443 | Lores Roeder | Pharmacist | 5721 Alder St, Lake Charles, LA 70605-0496 | 2014-01-29 |
| 1508290768 | Shanna Tiffany Simon | Pharmacist | 899 N Highway 171, Lake Charles, LA 70611-5034 | 2013-08-23 |
| 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.