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

Nathan J Ambrose, PA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1326694076

Nathan J Ambrose, PA is a Physician Assistant in Lafayette, Louisiana. Qualified in 2020, 6 years ago. Practices with Intermountain Medical Group Grand Junction, LLC, a 299-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
6
Licensed in
LA
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

5000 Ambassador Caffery Pkwy Ste A
Lafayette, LA 70508-6984
Phone: (337) 470-3580
Fax: (337) 470-3586
Show map & directions

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

Additional practice locations (1)

  • 625 Old Peachtree Rd Nw, Suwanee, GA 30024-2937 — (810) 625-4218

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 324792 (LA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1326694076
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 16, 2019
Last updated in NPPESMarch 7, 2023
Certification dateNovember 9, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Intermountain Medical Group Grand Junction, Llc — 299 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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