Individual provider Active NPI

Dennis James Guidry Jr., NP

  • Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1194723627
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN081497 - AP04680 Issued in LA
Practice address
2730 Ambassador Caffery Pkwy
Lafayette, LA 70506-5904
Phone
(337) 988-1585
Fax
(337) 981-9624
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN081497 - AP04680 LA Primary

Addresses

Primary practice location

2730 Ambassador Caffery Pkwy
Lafayette, LA 70506-5904

Mailing address

PO Box 4176
Houma, LA 70361-4176
Phone (985) 876-0300

Other identifiers 2

IdentifierTypeStateIssuer
P00226977OtherLARR MEDICARE
1622435MedicaidLA

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN081497 - AP04680LAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1194723627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4176",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703614176",
            "telephone_number": "985-876-0300",
            "fax_number": "985-872-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705065904",
            "telephone_number": "337-988-1585",
            "fax_number": "337-981-9624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIDRY",
        "first_name": "DENNIS",
        "middle_name": "JAMES",
        "name_suffix": "Jr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN081497 - AP04680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00226977",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1622435",
            "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 Oct 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.