NPIMap

Individual provider Active NPI

Codie Jessica Lee Guidry, N.P.

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1336506922
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP08635 Issued in LA
Practice address
277 N Highway 171 Ste 10
Lake Charles, LA 70611-5374
Phone
(337) 217-7762
NPI assigned
Jan 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN128288 LA
Family Nurse Practitioner 363LF0000X AP08635 LA Primary

Addresses

Primary practice location

277 N Highway 171 Ste 10
Lake Charles, LA 70611-5374

Mailing address

277 N Highway 171 Ste 10
Lake Charles, LA 70611-5374
Phone (337) 217-7762

Other practice location 1

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 312-8258

Other identifiers 1

IdentifierTypeStateIssuer
2409891MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL clee@imperialhealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160229001603 LA Practitioner - Nurse Practitioner 0244535276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imperial Health LLPGroup PAC ID 7719886779, 75 clinicians

Practice addresses (Care Compare)

277N Hwy 171
Suite 8
Lake Charles, LA 70611-5374
Phone (337) 312-0030

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN128288LAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Health LLP CurrentSince Jan 28, 2016 Accepting new patients
Calcasieu Cameron Hospital Medicine Group LLC CurrentSince Nov 1, 2019 Accepting new patients
Imperial Health, LLP CurrentSince Jan 28, 2016 Accepting new patients

Locations

607 N Thomson Ave
Iowa, LA 70647
Phone (337) 582-5555

501 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 312-8258

277 N Highway 171
Ste 10
Lake Charles, LA 70611
Phone (337) 217-7762

277 N Highway 171
Ste 8
Moss Bluff, LA 70611
Phone (337) 312-0030

701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4270

Interoperability endpoints

  • Direct secure messaging: codie.guidry@1288.direct.myezyaccess.com

Organizations & group practices 3

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1336506922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 N HIGHWAY 171 STE 10",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706115374",
            "telephone_number": "337-217-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 N HIGHWAY 171 STE 10",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706115374",
            "telephone_number": "337-217-7762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Dr Michael Debakey Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706015724",
            "country_code": "US",
            "telephone_number": "337-312-8258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE GUIDRY",
        "first_name": "CODIE",
        "middle_name": "JESSICA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-27",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN128288",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2409891",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "clee@imperialhealth.com",
            "affiliation": "N",
            "address_1": "277 N Highway 171 Ste 10",
            "city": "Lake Charles",
            "state": "LA",
            "country_code": "US",
            "postal_code": "706115374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.