Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ccp Primary Care Center

Organization Pain Medicine Physician · NPI 1336115997

Ccp Primary Care Center is a Pain Medicine Physician in Lafayette, Louisiana. Licensed in Louisiana. Registered with an NPI since 2006.

Licensed in
LA
In the registry since
2006
Specialties on file
2

Practice location Address checks out

1101 Eraste Landry Rd
Lafayette, LA 70506-3043
Phone: (337) 289-6690
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence AP04512 (LA)
Pain Medicine Physician Taxonomy 208VP0000X · Licence 022833 (LA)

Record details

NPI number1336115997
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Grover Phipps — Managing Partner · (337) 289-6690
NPI enumeratedFebruary 24, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address1101 Eraste Landry Rd, Lafayette, LA 70506-3043

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