| One Telemed Llc | |
|
1001 W Pinhook Road Building 3 Suite 219 Lafayette LA 70503 | |
| (337) 565-0843 | |
| (337) 205-4150 |
| Full Name | One Telemed Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1001 W Pinhook Road, Lafayette, Louisiana |
| Authorized Official Name and Position | Charles Edwards (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3375650843 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| One Telemed Llc 1001 W Pinhook Road Building 3 Suite 219 Lafayette LA 70503 Ph: (337) 565-0843 | One Telemed Llc 1001 W Pinhook Road Building 3 Suite 219 Lafayette LA 70503 Ph: (337) 565-0843 |
| NPI Number | 1750808911 |
|---|---|
| Provider Enumeration Date | 08/28/2017 |
| Last Update Date | 08/28/2017 |
| Medicare PECOS PAC ID | 2961886502 |
|---|---|
| Medicare Enrollment ID | O20220831002916 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750808911 | NPI | - | NPPES |
| Provider Name | Angela Ekeresi Green |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114196995 PECOS PAC ID: 0547386054 Enrollment ID: I20100921001432 |
| Provider Name | Aleshia Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467818880 PECOS PAC ID: 1658705991 Enrollment ID: I20191219002424 |
| Provider Name | Olumuyiwa Abdul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285898940 PECOS PAC ID: 2264600345 Enrollment ID: I20200423000347 |
| Provider Name | Ja'quay Brister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417420365 PECOS PAC ID: 3678959376 Enrollment ID: I20221004001453 |
| Provider Name | Nancy Ariwodo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376169979 PECOS PAC ID: 5294104840 Enrollment ID: I20221205000093 |
| Provider Name | Dionna Crespo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912565698 PECOS PAC ID: 9931520640 Enrollment ID: I20221206000409 |
| Provider Name | Jada Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659057040 PECOS PAC ID: 0143638049 Enrollment ID: I20240605004177 |
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