| Louisiana Stat Care LLC | |
|
11055 Shoe Creek Dr Baton Rouge LA 70818-4022 | |
| (225) 261-4493 | |
| Not Available |
| Full Name | Louisiana Stat Care LLC |
|---|---|
| Speciality | General Practice |
| Location | 11055 Shoe Creek Dr, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Amanda Woodard (OWNER) |
| Authorized Official Contact | 2252614493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisiana Stat Care LLC 11055 Shoe Creek Dr Baton Rouge LA 70818-4022 Ph: (225) 261-4493 | Louisiana Stat Care LLC 11055 Shoe Creek Dr Baton Rouge LA 70818-4022 Ph: (225) 261-4493 |
| NPI Number | 1891517512 |
|---|---|
| Provider Enumeration Date | 10/25/2024 |
| Last Update Date | 01/14/2025 |
| Certification Date | 01/14/2025 |
| Medicare PECOS PAC ID | 3870028491 |
|---|---|
| Medicare Enrollment ID | O20241119004702 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891517512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| 261QU0200X | Clinic/center - Urgent Care | () | Secondary |
| Provider Name | Norman G Neal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821089822 PECOS PAC ID: 3678552007 Enrollment ID: I20040719000397 |
| Provider Name | Rachel Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962753616 PECOS PAC ID: 2466757042 Enrollment ID: I20160218001964 |
| Provider Name | Keturiah N Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952759193 PECOS PAC ID: 9133414675 Enrollment ID: I20160823003108 |
| Provider Name | Rosaline OSU |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235653890 PECOS PAC ID: 3072885987 Enrollment ID: I20170826000173 |
| Provider Name | Jennifer H Laws |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841713716 PECOS PAC ID: 6709151616 Enrollment ID: I20171003005813 |
| Provider Name | Ashley N Haney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497269666 PECOS PAC ID: 2466711171 Enrollment ID: I20180125000730 |
| Provider Name | Crissy D Devall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598250870 PECOS PAC ID: 4284983164 Enrollment ID: I20180827001518 |
| Provider Name | Christopher B Staggers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184283236 PECOS PAC ID: 8820327778 Enrollment ID: I20190903001064 |
| Provider Name | Rebekah J Schmieder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285293464 PECOS PAC ID: 0749519494 Enrollment ID: I20190906000069 |
| Provider Name | Angela D Coss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356974265 PECOS PAC ID: 9739518200 Enrollment ID: I20200403001580 |
| Provider Name | Alise Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932727286 PECOS PAC ID: 9638594054 Enrollment ID: I20200803000836 |
| Provider Name | Kyle Leblanc |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306446414 PECOS PAC ID: 3577975911 Enrollment ID: I20201209001271 |
| Provider Name | Cody M Favaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023619277 PECOS PAC ID: 9032524046 Enrollment ID: I20210224000822 |
| Provider Name | Katherine Leblanc |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043812555 PECOS PAC ID: 5496161762 Enrollment ID: I20210311000429 |
| Provider Name | Rebecca Chair Muzika |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396318978 PECOS PAC ID: 6204226111 Enrollment ID: I20211208003208 |
| Provider Name | Deanna N Ibrahim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497473268 PECOS PAC ID: 6204291412 Enrollment ID: I20230421002631 |
| Provider Name | Angela D Kennerly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275249088 PECOS PAC ID: 8527424001 Enrollment ID: I20230525003279 |
| Provider Name | Whitney Cheryl Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851147235 PECOS PAC ID: 3870060866 Enrollment ID: I20260428000661 |
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