Mica Goulbourne, MD

Primary specialty

Child Abuse Pediatrics PhysicianTaxonomy code 2080C0008X

License

346102 Issued in LA

Practice address

1140 Calhoun St
New Orleans, LA 70118-5962

Phone

(504) 896-9827

NPI assigned

Mar 25, 2019

Last updated

Aug 7, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Medical College of Georgia School of Medicine, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Childrens Hospital Medical Practice Corporation

  • Pediatrics Physician
  • New Orleans, LA
  • NPI 1821090713

  Child Abuse Pediatrics

  Medicare reassignment NPD
• Bayou Pediatric Associates, Apmc

  • Pediatrics Physician
  • Houma, LA
  • NPI 1710061627
  NPD (past)

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1093276966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 POYDRAS ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701631101",
            "telephone_number": "504-527-9952",
            "fax_number": "504-527-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 CALHOUN ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185962",
            "telephone_number": "504-896-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULBOURNE",
        "first_name": "MICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "LA",
            "license": "346102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Goudeau
• Colin M Goudelocke, M.D.
• Katherine Anders Goudelocke, M.D.
• Candy Gougis
• Nina Marie Gougisha
• Haley Gould, MD
• Harry J. Gould III, MD
• Thattil Pavunny Gouri, MD
• Kearra Gourrier, BA
• Laurel Gourrier

• Pediatrics Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.