MR. LYLE EVERETT BOARD (NPI# 1962440404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962440404 |
| Entity Type | Individual |
| Full Name | MR. LYLE EVERETT BOARD |
| Credential | ATC, CSCS |
| Practice Address |
8080 Bluebonnet Blvd Baton Rouge LA 70810-7827 |
| Practice Telephone | 2254087990 |
| Practice Fax Number | 2254087989 |
| Mailing Telephone | 2254087990 |
| Mailing Fax Number | 2254087989 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225500000X | Specialist/Technologist | J00203 | LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | STATE LICENSE | J00203 | 01 |
| Street Address |
8080 BLUEBONNET BLVD |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70810-7827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324549 | Lawrence L Braud | Specialist | 8080 Bluebonnet Blvd, Ste 2222, Baton Rouge, LA 70810-7828 | 2005-05-31 |
| 1740821875 | Eleanor Catherine Brandon | Physician Assistant | 8080 Bluebonnet Blvd, Suite 1000, Baton Rouge, LA 70810-7827 | 2019-09-30 |
| 1891254595 | Ryan Delane Jenkins | Nurse Anesthetist, Certified Registered | 8080 Bluebonnet Blvd, Baton Rouge, LA 70810-7827 | 2019-03-13 |
| 1326516121 | Chelsea Leigh Richard | Occupational Therapist | 8080 Bluebonnet Blvd, Baton Rouge, LA 70810-7827 | 2018-11-09 |
| 1669902136 | Shellie Richardson | Specialist/Technologist, Other | 8080 Bluebonnet Blvd, Baton Rouge, LA 70810-7827 | 2017-06-15 |
| 1497281539 | Steven Kyle Poche | Prevention Professional | 8080 Bluebonnet Blvd, Suite 110, Baton Rouge, LA 70810-7827 | 2017-05-11 |
| 1699208868 | Kallie R Lebourgeois | Audiologist-Hearing Aid Fitter | 8080 Bluebonnet Blvd, Suite 2121, Baton Rouge, LA 70810-7827 | 2017-04-05 |
| 1639616576 | Eva Amanda Dodge | Physician Assistant | 8080 Bluebonnet Blvd, Suite 1000, Baton Rouge, LA 70810-7827 | 2017-01-30 |
| 1164971859 | Surgical Specialty Center of Baton Rouge | Pharmacy | 8080 Bluebonnet Blvd, Baton Rouge, LA 70810-7827 | 2016-09-23 |
| 1790136125 | Maddie Clare Windstein | Physician Assistant | 8080 Bluebonnet Blvd, Suite 1000, Baton Rouge, LA 70810-7827 | 2016-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639734973 | Baton Rouge Clinic, A Medical Corporation | Podiatrist | 8160 Ymca Blvd, Suite C, Baton Rouge, LA 70810 | 2019-05-02 |
| 1699278135 | Taylor Denise Debourg | Specialist/Technologist | 8921 Boone Drive, Baton Rouge, LA 70810 | 2018-03-12 |
| 1528583945 | Baton Rouge Perio, L.L.C. | Dentist | 10723 N. Oak Hills Parkway, Bldg. B, Baton Rouge, LA 70810 | 2017-08-07 |
| 1902334931 | Reginald Shaffer | Counselor | 13621 Kenner Ave Apt C, Baton Rouge, LA 70810 | 2017-06-03 |
| 1770010381 | Keona Julien | Case Manager/Care Coordinator | 9270 Siegen Ln Suite 101, Baton Rouge, LA 70810 | 2017-05-12 |
| 1205372893 | Grand Canyon Mobile Dentistry | Dentist | 8480 Bluebonnet Blvd Ste E, Baton Rouge, LA 70810 | 2017-01-06 |
| 1215395173 | Kimberly Booker | Counselor | 9371 Bimini Dr, Baton Rouge, LA 70810 | 2016-02-08 |
| 1710354022 | St Gabriel Health Clinic, Inc | Clinic/Center | 9211 Parkway Dr, Baton Rouge, LA 70810 | 2015-08-24 |
| 1942682430 | Jasmine Alexander | Counselor | 9270 Siegen Ln Bldg 101, Baton Rouge, LA 70810 | 2015-06-22 |
| 1073991535 | James Michael Robinson | Family Medicine | 12525 Perkins Rd Ste A, Baton Rouge, LA 70810 | 2015-05-15 |
| Find all providers in zip 70810 | ||||
| Taxonomy Code | 225500000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| General classification identifying individuals who are trained on a specific piece of equipment or technical procedure. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245275031 | Angela Gail Pinsonat | Specialist/Technologist | 7221 Lasalle Ave, Baton Rouge, LA 70806-8147 | 2006-06-17 |
| 1801021811 | Gray W. Barrow, M.d., Ltd. | Specialist/Technologist | 4545 Bluebonnet Blvd, Baton Rouge, LA 70809-5602 | 2009-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639526809 | Justin Charles Roy | Specialist/Technologist | 2425 W Congress St, Lafayette, LA 70506-5548 | 2016-05-18 |
| 1851762421 | Ryan Pickert | Specialist/Technologist | 1201 Clearview Pkwy, Metairie, LA 70001-3419 | 2015-10-08 |
| 1740596550 | Lucinda Yost Perret | Specialist/Technologist | 4200 Houma Blvd, Metairie, LA 70006-2970 | 2010-08-31 |
| 1659603959 | Mary Catherine Murphy | Specialist/Technologist | 2495 Shreveport Hwy, Pineville, LA 71360-4044 | 2010-02-11 |
| City | BATON ROUGE |
| Zip Code | 70810 |
Please comment or provide details below to improve the information on MR. LYLE EVERETT BOARD.
| 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.