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CITYBLOCK MEDICAL PRACTICE LA, LLC
NPI 1790447373
General Practice in Lafayette, LA

Active since October 11, 2021
1042 CAMELLIA BLVD, LAFAYETTE, LA 70508(800) 336-1100 Get Directions Write a Review

NPPES record last updated: October 11, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Cityblock Medical Practice La, Llc NPPES

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

CITYBLOCK MEDICAL PRACTICE LA, LLC (NPI 1790447373) is a healthcare organization registered as a general practice in Lafayette, Louisiana and active in the NPI registry since October 2021. The organization lists Devon Minerve, Corporate Counsel, as its authorized official.

NPPES Registry Identity

NPI1790447373
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameCITYBLOCK MEDICAL PRACTICE LA, LLC
Location Address1042 CAMELLIA BLVDLafayette, LA 70508-6680
Mailing Address495 Flatbush Ave Ste C5Brooklyn, NY 11225-3706 · (800) 336-1100
Phone(800) 336-1100
Organization SubpartNo
Authorized OfficialDevon MinerveCorporate Counsel · (202) 321-2528
Enumeration DateOctober 11, 2021
NPPES CertifiedOctober 7, 2021
✔ NPI 1790447373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

1042 CAMELLIA BLVD, Lafayette, LA 70508
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2291036

Cityblock Medical Practice, PA · Fort Wayne, IN
Expired · Oct 3, 2025
CLIA Number15D2291036
Laboratory TypePhysician Office
Certificate Effective DateOctober 4, 2023
Certificate Expiration DateOctober 3, 2025
Laboratory DirectorMichael Person
Laboratory Phone(800) 336-1100
Laboratory LocationCityblock Medical Practice, PA3030 Lake Avenue, Suite 21, Fort Wayne, IN 46805
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

SELLERS PHYSICAL THERAPY, LLC
Physical Therapist
1042 CAMELLIA BLVD, SUITE # 16
LAFAYETTE, LA 70508
Lafayette Parish (337) 739-9748

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 Cityblock Medical Practice La, LLC's NPI number?

The NPI number for Cityblock Medical Practice La, LLC is 1790447373. It was assigned to this organization in the NPPES registry on October 11, 2021.

Where is Cityblock Medical Practice La, LLC located?

Cityblock Medical Practice La, LLC is located at 1042 Camellia Blvd, Lafayette, LA 70508. The listed phone number is (800) 336-1100.

What is Cityblock Medical Practice La, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Cityblock Medical Practice La, LLC was last updated on October 11, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.