Active NPI
Joseph M Gautreaux, MD
- Otolaryngology Physician
- Kenner, LA
National Provider Identifier
1326179508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 013371
- Legal business name
- JOSEPH M GAUTREAUX, MD
- Practice address
- 1302 Williams Blvd
Kenner, LA 70062 - Phone
- (504) 464-8683
- Fax
- (504) 464-9100
- NPI assigned
- Mar 8, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joseph M Gautreaux, III III, M.D.
- Title
- Owner
- Phone
- (504) 464-8683
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | MD.013371 | LA | |
| Otolaryngology Physician | 207Y00000X | 013371 | LA | Primary |
Addresses
Primary practice location
1302 Williams Blvd
Kenner, LA 70062
Mailing address
1302 Williams Blvd
Kenner, LA 70062
Phone (504) 464-8683
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1307505 | Medicaid | LA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 19D0457773 | Joseph M Gautreaux III MD | Certificate of waiver | Jul 8, 2028 |
National Provider Directory
National Provider DirectoryLocations
200 W Esplanade Ave
Ste 120
Kenner, LA 70065
Phone (504) 821-8158
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Kenner, LA
- NPI 1568730778
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1294358400000",
"number": "1326179508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1302 WILLIAMS BLVD",
"city": "KENNER",
"state": "LA",
"postal_code": "70062",
"telephone_number": "504-464-8683",
"fax_number": "504-464-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1302 WILLIAMS BLVD",
"city": "KENNER",
"state": "LA",
"postal_code": "70062",
"telephone_number": "504-464-8683",
"fax_number": "504-464-9100"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOSEPH M GAUTREAUX, MD",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-08",
"last_updated": "2011-01-07",
"status": "A",
"authorized_official_last_name": "GAUTREAUX, III",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "504-464-8683",
"authorized_official_name_suffix": "III",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": "LA",
"license": "MD.013371",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": "LA",
"license": "013371",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1307505",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kenner, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.