PERNELL JOSEPH SIMON (NPI# 1699878124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699878124 |
| Entity Type | Individual |
| Full Name | PERNELL JOSEPH SIMON |
| Credential | MD |
| Practice Address |
207 Westmark Blvd Lafayette LA 70506-7365 |
| Practice Telephone | 3379816811 |
| Practice Fax Number | 3379812024 |
| Mailing Telephone | 3379816811 |
| Mailing Fax Number | 3379812024 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2012-09-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 021638 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
207 WESTMARK BLVD |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70506-7365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235324831 | Acadiana Ambulatory Health Care Services, Inc. | General Practice | 207 Westmark Blvd, Lafayette, LA 70506-7365 | 2007-09-07 |
| 1831292358 | John Wiley Stafford | General Practice | 207 Westmark Blvd, Lafayette, LA 70506-7365 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417421447 | Maranda Washington | Student in an Organized Health Care Education/Training Program | 202 Reinhardt Drive, Lafayette, LA 70506 | 2019-01-12 |
| 1447742473 | Glenda Gravouilla Poulan | Driver | 330 Guilbeau Rd, Lafayette, LA 70506 | 2018-06-05 |
| 1194215905 | Angelica Plumbar | Case Manager/Care Coordinator | 1304 Bertrand Dr Ste B21304, Lafayette, LA 70506 | 2018-05-16 |
| 1801394820 | Acadiana Ambulatory Health Care Services | Non-Pharmacy Dispensing Site | 207 Westmark Blvd., Lafayette, LA 70506 | 2018-01-24 |
| 1578070041 | Kimberly Lois Robinson | Counselor | 203 Pinto St, Lafayette, LA 70506 | 2018-01-05 |
| 1558890814 | Shanece Marie Solomon | Speech-Language Pathologist | 326 Guilbeau Rd Apt 240, Lafayette, LA 70506 | 2017-06-08 |
| 1225565625 | Keena Lewis | Case Manager/Care Coordinator | 121 Kohen Luke Dr, Lafayette, LA 70506 | 2017-05-16 |
| 1326571498 | Natasha Deville | Community/Behavioral Health | 1408 W Willow St 162, Lafayette, LA 70506 | 2017-04-06 |
| 1952846826 | Mia D Arthur | Behavioral Analyst | 511 Monarch Dr, Lafayette, LA 70506 | 2016-12-30 |
| 1265983340 | Eric Prince | Specialist/Technologist | 202 Reinhardt Dr., Lafayette, LA 70506 | 2016-10-24 |
| Find all providers in zip 70506 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497313670 | Lake Professionals LLC | General Practice | 501 W Saint Mary Blvd Ste 210, Lafayette, LA 70506-4699 | 2019-06-03 |
| 1821420258 | Azar & Lahood Enterprises LLC | General Practice | 111 Saint Louis St, Lafayette, LA 70506-4538 | 2013-08-08 |
| 1215369665 | Minute Med-johnston LLC | General Practice | 2912 Johnston Street, Lafayette, LA 70503 | 2013-08-07 |
| 1942539044 | Lafayette Diagnostics, Inc. | General Practice | 1019 Kaliste Saloom Rd, Suite # 711, Lafayette, LA 70508-4935 | 2009-12-18 |
| 1386972800 | Theresa Orecchia | General Practice | 285 Exempla Circle, Lafayette, CO 80026 | 2009-11-20 |
| 1760674717 | Northside High School Health Clinic | General Practice | 301 Dunand St, Lafayette, LA 70501-2215 | 2007-08-14 |
| 1225156151 | William Frederick Kortum IIi | General Practice | 3414 Moss St Ste A, Lafayette, LA 70507-6107 | 2007-03-27 |
| 1598818908 | George Edward Cobb IIi | General Practice | 3501 School Street, Lafayette, CA 94549 | 2007-01-19 |
| 1013087154 | Doctors Hearing Center LLC Lxxiv | General Practice | 4414 Johnston Street, Suite D, Lafayette, LA 70503 | 2006-11-08 |
| 1366423691 | Stanley Thomas Hoover | General Practice | 1144 Coolidge, Suite D, Lafayette, LA 70503 | 2005-11-14 |
| Find all providers in LAFAYETTE | ||||
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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.