Individual provider Active NPI

Brian Phillip Guidry, MD

  • Emergency Medicine Physician
  • Covington, LA
National Provider Identifier
1174591390
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
24212 Issued in LA
Practice address
95 E Fairway Dr
Covington, LA 70433
Phone
(985) 867-4000
Fax
(985) 867-4001
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 24212 LA Primary

Addresses

Primary practice location

95 E Fairway Dr
Covington, LA 70433

Mailing address

PO Box 740550
New Orleans, LA 70174
Phone (504) 366-7638

Other identifiers 1

IdentifierTypeStateIssuer
1489654MedicaidLA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031114000202 LA Practitioner - Emergency Medicine 2567376593 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24212LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Van Meter Emergency Physicians Inc. Apmc Emergency Medicine CurrentSince Apr 1, 2009 Accepting new patients
Acs Primary Care Physicians Louisiana PC Emergency Medicine CurrentSince Feb 1, 2014 Accepting new patients
Washington Parish Emergency Physicians Group LLC Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Convenient Care LLC Emergency Medicine CurrentSince Aug 2, 2010 Accepting new patients
Thibodaux Emergency Physicians Group LLC Emergency Medicine CurrentSince Nov 9, 2016 Accepting new patients
Convenient Care LLC CurrentSince Aug 2, 2010 Accepting new patients
St Tammany Emergency Physicians Group LLC Emergency Medicine CurrentSince Jun 1, 2019 Accepting new patients
Terrebonne Parish Hospital Service District #1 Past Accepting new patients
Van Meter MD & Associates Past Accepting new patients

Locations

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

12525 Perkins Rd
#B
Baton Rouge, LA 70810
Phone (225) 819-8857

433 Plaza St
Bogalusa, LA 70427
Phone (985) 730-6700

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

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

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1174591390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740550",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70174",
            "telephone_number": "504-366-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 E FAIRWAY DR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "70433",
            "telephone_number": "985-867-4000",
            "fax_number": "985-867-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIDRY",
        "first_name": "BRIAN",
        "middle_name": "PHILLIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "24212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1489654",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.