Individual provider Active NPI

Kristy McCoy Ganucheau, LOTR

  • Occupational Therapist
  • New Orleans, LA
National Provider Identifier
1538416797
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTT.200572 Issued in LA
Practice address
1055 Saint Charles Ave Ste 400
New Orleans, LA 70130-3994
Phone
(225) 802-7929
NPI assigned
Aug 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTT.200572 LA Primary

Addresses

Primary practice location

1055 Saint Charles Ave Ste 400
New Orleans, LA 70130-3994

Mailing address

105 Scarlett LN
Montz, LA 70068-8973
Phone (225) 802-7929

Other practice location 1

105 Scarlett Ln
Montz, LA 70068-8973
Phone (225) 802-7929

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

State licenses

LicenseStateTypeSpecialty
OTT.200572LAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kipp New Orleans, Inc. CurrentSince Sep 8, 2024 Accepting new patients
Sprout Pediatric Therapy Services, LLC PastSince May 16, 2021 Accepting new patients
Sprout Pediatric Therapy Services, LLC PastSince Jun 22, 2021 Accepting new patients

Locations

1055 Saint Charles Ave
Ste 400
New Orleans, LA 70130
Phone (225) 802-7929

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1538416797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SCARLETT LN",
            "city": "MONTZ",
            "state": "LA",
            "postal_code": "700688973",
            "telephone_number": "225-802-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 SAINT CHARLES AVE STE 400",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701303994",
            "telephone_number": "225-802-7929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Scarlett Ln",
            "address_purpose": "LOCATION",
            "city": "Montz",
            "state": "LA",
            "postal_code": "700688973",
            "country_code": "US",
            "telephone_number": "225-802-7929",
            "fax_number": "504-662-1527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANUCHEAU",
        "first_name": "KRISTY",
        "middle_name": "MCCOY",
        "credential": "LOTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "OTT.200572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.