Individual provider Active NPI

Tessa Graham Truxillo, NP

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1518534403
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
218891 Issued in LA
Practice address
8415 Goodwood Blvd Ste 100
Baton Rouge, LA 70806-7851
Phone
(225) 765-5500
Fax
(225) 765-5634
NPI assigned
Jun 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 218891 LA Primary

Addresses

Primary practice location

8415 Goodwood Blvd Ste 100
Baton Rouge, LA 70806-7851

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 765-5500

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tgraham2342817@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

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
I20210805002766 LA Practitioner - Nurse Practitioner 6901200435 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218891LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Aug 1, 2021 Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner Current Accepting new patients
Our Lady of the Lake Physician Group, LLC CurrentSince Aug 1, 2021 Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner PastSince Jun 1, 2021 Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

8415 Goodwood Blvd
Ste 100
Baton Rouge, LA 70806
Phone (225) 765-5633

311 Veterans Blvd
Ste B
Denham Springs, LA 70726
Phone (225) 665-4554

Interoperability endpoints

  • Direct secure messaging: tgraham2342817@direct.casso.us.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1518534403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-5500",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 GOODWOOD BLVD STE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067851",
            "telephone_number": "225-765-5500",
            "fax_number": "225-765-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUXILLO",
        "first_name": "TESSA",
        "middle_name": "GRAHAM",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "218891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgraham2342817@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tgraham2342817@direct.casso.us.com",
            "address_1": "8415 Goodwood Blvd Ste 100",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708067851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8415 Goodwood Blvd Ste 100",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708067851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.