Active NPI
Dana M Bourgeois, MS, CCC-CLP
- Speech-Language Pathologist
- Thibodaux, LA
National Provider Identifier
1457754152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6887
- Practice address
- 270 Highway 3185
Thibodaux, LA 70301-7466 - Phone
- (985) 449-0944
- Fax
- (985) 449-0945
- NPI assigned
- Oct 8, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6887 | LA | Primary |
Addresses
Primary practice location
270 Highway 3185
Thibodaux, LA 70301-7466
Mailing address
270 Highway 3185
Thibodaux, LA 70301-7466
Phone (985) 449-0944
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6887 | LA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Center for Pediatric Therapy,LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Physical Therapist
- Thibodaux, LA
- NPI 1982825774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412812800000",
"number": "1457754152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "270 HIGHWAY 3185",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703017466",
"telephone_number": "985-449-0944",
"fax_number": "985-449-0945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "270 HIGHWAY 3185",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703017466",
"telephone_number": "985-449-0944",
"fax_number": "985-449-0945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURGEOIS",
"first_name": "DANA",
"middle_name": "M",
"credential": "MS, CCC-CLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-08",
"last_updated": "2014-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "6887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thibodaux, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.