Gulf Coast Sport and Spine

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1800 Issued in LA

Legal business name

GULF COAST SPORT AND SPINE

Practice address

3941 Houma Blvd Ste 2a
Metairie, LA 70006-2920

Phone

(504) 372-4062

NPI assigned

Oct 16, 2017

Organization subpart

No

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

Authorized official

Name

Michael Lebourgeois, DCNPI 1659713915

Title

Owner

Phone

(504) 372-4062

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Lebourgeois, D.C.

  • Chiropractor
  • Metairie, LA
  • NPI 1659713915
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522022400000",
    "number": "1144731399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3941 HOUMA BLVD STE 2A",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062920",
            "telephone_number": "504-372-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3941 HOUMA BLVD STE 2A",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062920",
            "telephone_number": "504-372-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST SPORT AND SPINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-16",
        "last_updated": "2018-03-26",
        "status": "A",
        "authorized_official_last_name": "LEBOURGEOIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-372-4062",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phlicious Guillory, LMT
• Shane Guillory, M.D.
• Emmanuel J Guillot IV, LMSW
• Gulf Coast After Hours Uptown
• Gulf Coast Ambulatory Anesthesia, LLC
• Gulf Coast Teaching Family Services
• Gulf Coast Teaching Family Services, Inc.
• Gulf Coast Teaching Family Services, Inc.
• Gulf Coast Teaching Family Services, Inc.
• Gulf Coast Teaching Family Services, Inc.

• Chiropractor in Metairie, LA
• Providers in Metairie, LA by specialty
• Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.