Active NPI
John Wells Gaudet, MD
- Pediatrics Physician
- Hattiesburg, MS
National Provider Identifier
1144285420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 13989
- Practice address
- 39 Franklin Rd
Ste. 200
Hattiesburg, MS 39402-1588 - Phone
- (601) 296-3050
- Fax
- (601) 296-3013
- NPI assigned
- Apr 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 13989 | MS | Primary |
Addresses
Primary practice location
39 Franklin Rd
Ste. 200
Hattiesburg, MS 39402-1588
Mailing address
39 Franklin Rd
Ste. 200
Hattiesburg, MS 39402-1588
Phone (601) 296-3050
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09016137 | Medicaid | MS | |
| 00116155 | Medicaid | MS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | john.gaudet.1@1930.direct.athenahealth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1144285420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 FRANKLIN RD",
"address_2": "STE. 200",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394021588",
"telephone_number": "601-296-3050",
"fax_number": "601-296-3013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 FRANKLIN RD",
"address_2": "STE. 200",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394021588",
"telephone_number": "601-296-3050",
"fax_number": "601-296-3013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUDET",
"first_name": "JOHN",
"middle_name": "WELLS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2020-08-27",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MS",
"license": "13989",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09016137",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00116155",
"state": "MS"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "john.gaudet.1@1930.direct.athenahealth.com",
"affiliation": "N",
"endpointDescription": "AMR direct address",
"address_1": "39 Franklin Rd",
"address_2": "Ste. 200",
"city": "Hattiesburg",
"state": "MS",
"country_code": "US",
"postal_code": "394021588",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.