Individual provider Active NPI

Jude L Guillory, CRNA

  • Certified Registered Nurse Anesthetist
  • Lafayette, LA
National Provider Identifier
1053554030
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP05767 Issued in LA
Practice address
1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783
Phone
(337) 988-5646
Fax
(337) 988-4298
NPI assigned
Apr 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP05767 LA Primary

Addresses

Primary practice location

1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783

Mailing address

1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783
Phone (337) 988-5646

Other identifiers 1

IdentifierTypeStateIssuer
1889300MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090521000583 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557410552 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology and Pain Consultants LLCGroup PAC ID 3870490402, 48 clinicians
Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians
Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians

Practice addresses (Care Compare)

1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5784
Phone (337) 988-5646

1211 Coolidge Blvd
Suite 302
Lafayette, LA 70503-2636
Phone (337) 289-8249

2390 W Congress St
University Hosp Clinics
Lafayette, LA 70506-4205
Phone (337) 261-6000

Hospital & facility affiliations

  • Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002
  • Park Place Surgical Hospital Hospital, Lafayette, LA, CCN 190255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP05767LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2024 Accepting new patients
Precision Anesthesia of Lafayette LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 4, 2023 Accepting new patients
Anesthesiology & Pain Consultants, LLC CurrentSince Feb 4, 2009 Accepting new patients

Locations

1103 Kaliste Saloom Rd
Ste 304
Lafayette, LA 70508
Phone (318) 981-3546

1101 Kaliste Saloom Rd
Lafayette, LA 70508
Phone (337) 231-5775

4811 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 237-8119

443 Heymann Blvd
Lafayette, LA 70503
Phone (337) 269-1126

4811 Ambassador Caffery Pkwy
Ste 100
Lafayette, LA 70508
Phone (337) 237-8119

1211 Coolidge Blvd
Ste 302
Lafayette, LA 70503
Phone (337) 289-8245

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1053554030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 KALISTE SALOOM RD",
            "address_2": "SUITE 304",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085783",
            "telephone_number": "337-988-5646",
            "fax_number": "337-988-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 KALISTE SALOOM RD",
            "address_2": "SUITE 304",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085783",
            "telephone_number": "337-988-5646",
            "fax_number": "337-988-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLORY",
        "first_name": "JUDE",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-07",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP05767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1889300",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.