DR. RANDAL LEE PILGRIM (NPI# 1750344248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750344248 |
| Entity Type | Individual |
| Full Name | DR. RANDAL LEE PILGRIM |
| Credential | M.D. |
| Practice Address |
1105 Kaliste Saloom Rd Lafayette LA 70508-5705 |
| Mailing Address |
200 Corporate Blvd Suite 201 Lafayette LA 70508-3870 |
| Practice Telephone | 8008939698 |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2012-12-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 13341R | LA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 13341R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1562416 | 05 |
| Street Address |
1105 KALISTE SALOOM RD |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-5705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609845130 | Emergency Group of Lafayette LLC | Physician Assistant | 1105 Kaliste Saloom Rd, Lafayette, LA 70508-5705 | 2006-03-16 |
| 1407468135 | Ronda Vincent | Registered Nurse | 1105 Kaliste Saloom Rd, Lafayette, LA 70508-5705 | 2020-08-24 |
| 1154930915 | Richard Jude Leblanc | Registered Nurse | 1105 Kaliste Saloom Rd, Lafayette, LA 70508-5705 | 2020-07-28 |
| 1275164261 | Garrett Joseph Darbonne | Nurse Anesthetist, Certified Registered | 1105 Kaliste Saloom Rd, Lafayette, LA 70508-5705 | 2020-01-29 |
| 1942717269 | Joshua Mark Thigpen | Nurse Anesthetist, Certified Registered | 1105 Kaliste Saloom Rd, Lafayette, LA 70508-5705 | 2018-01-09 |
| 1932645090 | Jarod Boudreaux | Nurse Anesthetist, Certified Registered | 1105 Kaliste Saloom Rd, Lafayette, LA 70508-5705 | 2017-01-13 |
| 1124489372 | Crystal White Jeansonne | Nurse Practitioner | 1105 Kaliste Saloom Rd, Lafayette, LA 70508-5705 | 2016-03-16 |
| 1184812182 | Heart Hospital of Acadiana, LLC | Special Hospital | 1105 Kaliste Saloom Rd, Lafayette, LA 70508-5705 | 2007-10-04 |
| 1902822786 | Lafayette Heart Hospital LLC | General Acute Care Hospital | 1105 Kaliste Saloom Rd, Lafayette, LA 70508-5705 | 2006-07-14 |
| 1336182989 | Prabhakara Venkata Reddy | Emergency Medicine | 1105 Kaliste Saloom Rd, Lafayette, LA 70508-5705 | 2006-06-13 |
| 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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760913891 | Nathan Francis Marcinkowski | Emergency Medicine | 216 N 4th St Ste 205, Lafayette, IN 47901-1323 | 2017-03-21 |
| 1134549322 | Marc Fernandez | Emergency Medicine | 121 Rue Louis Xiv Bldg 5, Lafayette, LA 70508-5786 | 2014-04-26 |
| 1710328653 | Medexpress Urgent Care, PC - Indiana | Emergency Medicine | 102 Sagamore Pkwy S, Lafayette, IN 47905-4745 | 2013-07-08 |
| 1467751354 | Devan Guidry Szczepanski | Emergency Medicine | 619 Saint Catherine St, Lafayette, LA 70506-4328 | 2011-03-18 |
| 1730359977 | Tonya Boudreaux | Emergency Medicine | 4600 Ambassador Caffery- Emergency Dept., Lafayette, LA 70508 | 2008-03-04 |
| 1063692481 | Braden Conrad Despot | Emergency Medicine | 200 Travis St Ste 201, Lafayette, LA 70503-2447 | 2007-11-14 |
| 1699970830 | Charles P Gillespie | Emergency Medicine | 2849 Crater Lake Ln, Lafayette, CO 80026-3488 | 2007-06-18 |
| 1730239542 | Charles T. Clemons | Emergency Medicine | 926 Raintree Pl, Lafayette, CA 94549-4816 | 2007-01-12 |
| 1811076995 | Brad Alan Boudreaux | Emergency Medicine | 3619 Ambassador Caffery Pkwy, Bldg E, Lafayette, LA 70503-5132 | 2006-11-02 |
| 1528158060 | Joseph C Ryan | Emergency Medicine | 607 Greenbriar Rd, Lafayette, LA 70503-0000 | 2006-10-13 |
| 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.