Andre Joseph Guidry, OT

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

Z11343 Issued in LA

Practice address

108 Ellington Dr
Thibodaux, LA 70301-8045

Phone

(985) 637-1004

Fax

(985) 369-4568

NPI assigned

Mar 8, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifespan Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Chauvin, LA
  • NPI 1700973054
  NPD (past)

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1548568090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 ELLINGTON DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703018045",
            "telephone_number": "985-637-1004",
            "fax_number": "985-369-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 ELLINGTON DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703018045",
            "telephone_number": "985-637-1004",
            "fax_number": "985-369-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIDRY",
        "first_name": "ANDRE",
        "middle_name": "JOSEPH",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-08",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "LA",
            "license": "Z11343",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "LA",
            "license": "Z11343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannan Gros
• Shenee Haas Gros, LPC
• Wilma Gros
• Ajah Guidroz
• Amber Guidry
• Cierra Guidry, BA
• Jennifer Marie Guidry, M.ED., PLPC
• Jolie Guidry, LSSP, NCSP
• Joshua Ryan Guidry, DDS
• Kyle J. Guidry, M.D.

• Physical Rehabilitation Occupational Therapist in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Physical Rehabilitation Occupational Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; 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.