Individual provider Active NPI

Gabrielle Julie Wurzlow, NP

  • Family Nurse Practitioner
  • Thibodaux, LA
National Provider Identifier
1467861609
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP07884 Issued in LA
Practice address
1320 Martin Luther King Dr
Thibodaux, LA 70301-4886
Phone
(985) 446-2021
Fax
(985) 447-1546
NPI assigned
Aug 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP07884 LA
Family Nurse Practitioner 363LF0000X AP07884 LA Primary

Addresses

Primary practice location

1320 Martin Luther King Dr
Thibodaux, LA 70301-4886

Mailing address

1320 Martin Luther King Dr
Thibodaux, LA 70301-4886
Phone (985) 446-2021

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141105002352 LA Practitioner - Nurse Practitioner 9931321098 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Institute of the South, LLCGroup PAC ID 3779497441, 145 clinicians
Kidney Center of South Louisiana, AMCGroup PAC ID 8820042757, 3 clinicians

Practice addresses (Care Compare)

1320 Martin Luther King Dr
Thibodaux, LA 70301-4886
Phone (985) 446-2021

604 N Acadia Rd
Suite 405
Thibodaux, LA 70301-4897
Phone (985) 446-0871

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP07884LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Medical Group CurrentSince Nov 14, 2017 Accepting new patients
South Louisiana Medical Associates CurrentSince Oct 11, 2017 Accepting new patients
Thibodaux Emergency Physicians Group LLC CurrentSince Nov 9, 2016 Accepting new patients
South Louisiana Medical Associates Family CurrentSince Oct 11, 2017 Accepting new patients
Kidney Center of South Louisiana, AMC CurrentSince Jul 1, 2023 Accepting new patients

Locations

1990 Industrial Blvd
Houma, LA 70363
Phone (985) 868-9300

1340 Grand Caillou Rd
Houma, LA 70363
Phone (985) 262-4424

8166 Main St
Houma, LA 70360
Phone (800) 456-9121

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

604 N Acadia Rd
Ste 405
Thibodaux, LA 70301
Phone (985) 446-0871

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFEIBA
  • Direct secure messaging: gwurzlow408137@direct.ochsner.org

Organizations & group practices 6

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 2

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": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1467861609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 MARTIN LUTHER KING DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014886",
            "telephone_number": "985-446-2021",
            "fax_number": "985-447-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MARTIN LUTHER KING DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014886",
            "telephone_number": "985-446-2021",
            "fax_number": "985-447-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURZLOW",
        "first_name": "GABRIELLE",
        "middle_name": "JULIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-12",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP07884",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP07884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.