CCP PRIMARY CARE CENTER
NPI 1336115997
Nurse Practitioner in Lafayette, LA

Active since February 24, 2006
1101 ERASTE LANDRY RD, LAFAYETTE, LA 70506(337) 289-6690 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Ccp Primary Care Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CCP PRIMARY CARE CENTER (NPI 1336115997) is a healthcare organization registered as a nurse practitioner in Lafayette, Louisiana and active in the NPI registry since February 2006. The organization lists Grover Phipps, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1336115997
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameCCP PRIMARY CARE CENTER
Location Address1101 ERASTE LANDRY RDLafayette, LA 70506-3043
Mailing Address1101 Eraste Landry RdLafayette, LA 70506-3043 · (337) 289-6690
Organization SubpartNo
Authorized OfficialGrover PhippsManaging Partner · (337) 289-6690
Enumeration DateFebruary 24, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
NPI 1336115997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in LA · AP04512
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedPain Medicine · Pain MedicineTaxonomy 208VP0000X · License 022833 (LA)
1101 ERASTE LANDRY RD, Lafayette, LA 70506

Other Identifiers 1

Medicaid14-47692LA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
1101 ERASTE LANDRY RD
LAFAYETTE, LA 70506
General Practice
1101 ERASTE LANDRY RD
LAFAYETTE, LA 70506

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ccp Primary Care Center's NPI number?

The NPI number for Ccp Primary Care Center is 1336115997. It was assigned to this organization in the NPPES registry on February 24, 2006.

Where is Ccp Primary Care Center located?

Ccp Primary Care Center is located at 1101 Eraste Landry Rd, Lafayette, LA 70506. The listed phone number is (337) 289-6690.

What is Ccp Primary Care Center's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Ccp Primary Care Center was last updated on September 11, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.