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

Mr. Ted Etell Fontenot, ANP

Individual provider Adult Health Nurse Practitioner · NPI 1598052052

Mr. Ted Etell Fontenot, ANP is a Nurse Practitioner in Lake Charles, Louisiana. Qualified in 2011, 15 years ago. Practices with Lake Charles Memorial Heart and Vascular Center, a 15-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
15
Licensed in
LA
In the registry since
2011
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Practice location Address checks out

1717 Oak Park Blvd Fl 2
Lake Charles, LA 70601-8990
Phone: (337) 494-3278
Fax: (337) 494-3240
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 122 W 4th St, Dequincy, LA 70633-3508 — (337) 494-3278
  • 109 W 4th St, Deridder, LA 70634-4849 — (337) 494-3278
  • 1322 Elton Rd Ste P, Jennings, LA 70546-4100 — (337) 494-3278
  • 913 E Kent Dr, Sulphur, LA 70663-5007 — (337) 527-3610

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence AP06448 (LA)

Record details

NPI number1598052052
Entity typeIndividual (Type 1)
GenderMale
Credentials ANP
Sole proprietorYes
NPI enumeratedJuly 6, 2011
Last updated in NPPESApril 27, 2022
Certification dateApril 27, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Lake Charles Memorial Heart And Vascular Center — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Lake Charles