Individual provider Active NPI

Tommie Landry Jr., MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Cut Off, LA
National Provider Identifier
1013573583
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
203777 Issued in LA
Practice address
144 W 134TH PL
Cut Off, LA 70345-4128
Phone
(985) 632-6233
Fax
(985) 632-7526
NPI assigned
May 10, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 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 203777 LA Primary

Addresses

Primary practice location

144 W 134TH PL
Cut Off, LA 70345-4128

Mailing address

144 W 134TH PL
Cut Off, LA 70345-4128
Phone (985) 632-6233

Other identifiers 1

IdentifierTypeStateIssuer
2500724MedicaidLA

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
I20190718000273 LA Practitioner - Nurse Practitioner 9638404254 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
203777LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lafourche Parish Hospital Service District No.1 CurrentSince Jan 7, 2024 Accepting new patients
Thibodaux Regional Network Development Corporation Current Accepting new patients
Sydney Burchfield, LLC CurrentSince Aug 1, 2024 Accepting new patients
Lafourche Parish Hospital Service District No.1 Past Accepting new patients

Locations

200 W 134th Pl
Cut Off, LA 70345
Phone (985) 325-9300

609 Brashear Ave
Morgan City, LA 70380
Phone (985) 300-6123

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

Interoperability endpoints

  • Direct secure messaging: tommie.landry.1@748.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/748/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lafourche Parish Hospital Service District No 1 23 clinicians
Sydney Burchfield LLC 5 clinicians

Practice addresses (Care Compare)

144 W 134TH PL
Cut Off, LA 70345-4128
Phone (985) 632-6233

609 Brashear Ave
Morgan City, LA 70380-3203
Phone (985) 300-6123

NPI Registry JSON

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1013573583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 W 134TH PL",
            "city": "CUT OFF",
            "state": "LA",
            "postal_code": "703454128",
            "telephone_number": "985-632-6233",
            "fax_number": "985-632-7526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 W 134TH PL",
            "city": "CUT OFF",
            "state": "LA",
            "postal_code": "703454128",
            "telephone_number": "985-632-6233",
            "fax_number": "985-632-7526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "TOMMIE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-10",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "203777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2500724",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cut Off, LA

Sources for this page

Verify at the official NPI Registry.