Individual provider Active NPI

Shawanna Marie Guillory, FNP

  • Family Nurse Practitioner
  • Broussard, LA
National Provider Identifier
1013344274
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP07537 Issued in LA
Practice address
811 Albertson Pkwy Ste G
Broussard, LA 70518-5256
Phone
(337) 290-8520
NPI assigned
Oct 3, 2013
Last updated
Jan 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP07537 LA Primary

Addresses

Primary practice location

811 Albertson Pkwy Ste G
Broussard, LA 70518-5256

Mailing address

PO Box 2651
Opelousas, LA 70571-2651
Phone (337) 384-9219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131101001213 LA Practitioner - Nurse Practitioner 6204061070 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Church Point Primary Care LLCGroup PAC ID 8426288622, 2 clinicians

Practice addresses (Care Compare)

202 W Murrell St
Church Point, LA 70525-2950
Phone (337) 684-1300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Healthcare Services CurrentSince Mar 1, 2021 Accepting new patients
Community Care Health Network LLC Nurse Practitioner CurrentSince Feb 22, 2024 Accepting new patients
Church Point Primary Care, LLC CurrentSince Sep 1, 2023 Accepting new patients
Icats Management Integrated Care and Transition Services LLC Nurse Practitioner PastSince Nov 18, 2013 Accepting new patients
Southern Family Medicine, LLC Family Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

2900 Westfork Dr
Ste 401
Baton Rouge, LA 70827
Phone (225) 953-0895

811 Albertson Pkwy
Ste G
Broussard, LA 70518
Phone (337) 290-8520

202 Murrell St
Church Point, LA 70525
Phone (337) 684-1300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20525/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1013344274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2651",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705712651",
            "telephone_number": "337-384-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 ALBERTSON PKWY STE G",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705185256",
            "telephone_number": "337-290-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLORY",
        "first_name": "SHAWANNA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2022-01-03",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP07537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broussard, LA

Sources for this page

Verify at the official NPI Registry.