NPIMap

Organization Active NPI

Gastroenterology Group, LLC

  • Gastroenterology Physician
  • Covington, LA
National Provider Identifier
1245272541
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROENTEROLOGY GROUP, LLC
Practice address
131 Cherokee Rose LN
Covington, LA 70433-7195
Phone
(985) 871-1721
Fax
(985) 871-4049
NPI assigned
Jun 12, 2006
Last updated
Jun 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Authorized official

Name
Hazel Brauen
Title
Practice Manager
Phone
(985) 871-1721

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

131 Cherokee Rose LN
Covington, LA 70433-7195

Mailing address

PO Box 848778
Boston, MA 02284-8778
Phone (985) 871-1721

Other identifiers 5

IdentifierTypeStateIssuer
1799181MedicaidLA
CG2313OtherLAMEDICARE RAILROAD
CK5954OtherMSMEDICARE RAILROAD
CN9069OtherLAMEDICARE RAILROAD
09015774MedicaidMS

Other names 2

  • Gastroenterology Group, A Medical Corporation Former legal business name
  • Gastroenterology Group, AMC Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address giasouthcentral-covington@directaddress.net Direct

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

58515 Pearl Acres Rd
Ofc
Slidell, LA 70461
Phone (985) 641-8982

Interoperability endpoints

  • Direct secure messaging: giasouthcentral-covington@directaddress.net
  • FHIR API: https://api.platform.athenahealth.com/2822/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1245272541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848778",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022848778",
            "telephone_number": "985-871-1721",
            "fax_number": "985-893-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 CHEROKEE ROSE LN",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337195",
            "telephone_number": "985-871-1721",
            "fax_number": "985-871-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "BRAUEN",
        "authorized_official_first_name": "HAZEL",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "985-871-1721"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1799181",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CG2313",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CK5954",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CN9069",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015774",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "giasouthcentral-covington@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "131 Cherokee Rose Ln",
            "city": "Covington",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704337195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Gastroenterology Group, A Medical Corporation",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Gastroenterology Group, AMC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.