Individual provider Active NPI

Gabrielle Givens

  • Family Medicine Physician
  • Mandeville, LA
National Provider Identifier
1306378252
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
323916 Issued in LA
Practice address
201 Saint Ann Dr Ste B
Mandeville, LA 70471-3472
Phone
(985) 626-1717
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 323916 LA Primary

Addresses

Primary practice location

201 Saint Ann Dr Ste B
Mandeville, LA 70471-3472

Mailing address

1202 S Tyler St
Covington, LA 70433-2330

Other identifiers 1

IdentifierTypeStateIssuer
323916OtherLALICENSE

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
I20200813002239 LA Practitioner - Family Practice 0446520001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Tammany Parish Hospital Service District No 1Group PAC ID 0749273761, shared by 6 NPIs, 162 clinicians

Practice addresses (Care Compare)

1202 S Tyler St
Covington, LA 70433-2330
Phone (985) 898-3743

201 Saint Ann Dr B
Mandeville, LA 70471-3219
Phone (985) 626-1717

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
323916LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Tammany Parish Hospital Service District No 1 CurrentSince May 23, 2024 Accepting new patients
St Tammany Parish Hospital Service District No 1 CurrentSince Aug 1, 2020 Accepting new patients

Locations

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

17240 Heartbeat Cir
Covington, LA 70435
Phone (985) 867-3073

1520 Highway 22 W
Madisonville, LA 70447
Phone (985) 773-1600

201 Saint Ann Dr
Ste B
Mandeville, LA 70471
Phone (985) 626-1717

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1306378252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 S TYLER ST",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SAINT ANN DR STE B",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713472",
            "telephone_number": "985-626-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIVENS",
        "first_name": "GABRIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "323916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "323916",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.