Individual provider Active NPI

Courtney Marie Guidry, PA-C

  • Physician Assistant
  • Beaumont, TX
National Provider Identifier
1396084992
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
755 N 11TH St Ste P5200
Beaumont, TX 77702
Phone
(409) 898-2994
Fax
(409) 899-5542
NPI assigned
Feb 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

755 N 11TH St Ste P5200
Beaumont, TX 77702

Mailing address

755 N 11TH St Ste P5200
Beaumont, TX 77702-1522
Phone (409) 898-2994

Other identifiers 1

IdentifierTypeStateIssuer
PA08276OtherTXTMB

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180103002804 TX Practitioner - Physician Assistant 9739486036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Medical Branch at Galveston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beaumont Internal Medicine and Geriatric Assoc.Group PAC ID 9032195789, 17 clinicians

Practice addresses (Care Compare)

755 N 11TH St
Suite P5200
Beaumont, TX 77702-1522
Phone 4098982994105

Hospital & facility affiliations

  • Harbor Home Health Home health agency, Beaumont, TX, CCN 679163
  • Centerwell Home Health Home health agency, Beaumont, TX, CCN 678039
  • Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034
  • Baptist Beaumont Hospital Hospital, Beaumont, TX, CCN 450346
  • Christus Jasper Memorial Hospital Hospital, Jasper, TX, CCN 450573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ahmad Medical PC Past Accepting new patients

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 5

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": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1396084992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST STE P5200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021522",
            "telephone_number": "409-898-2994",
            "fax_number": "409-898-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N 11TH ST STE P5200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77702",
            "telephone_number": "409-898-2994",
            "fax_number": "409-899-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIDRY",
        "first_name": "COURTNEY",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-04",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMB",
            "identifier": "PA08276",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.