Individual provider Active NPI

Therese Bourgeois Smith, RPH

  • Pharmacist
  • Gonzales, LA
National Provider Identifier
1598838245
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14976 Issued in LA
Practice address
1039 E Highway 30
Gonzales, LA 70737-4757
Phone
(225) 647-4182
Fax
(225) 644-0460
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14976 LA Primary

Addresses

Primary practice location

1039 E Highway 30
Gonzales, LA 70737-4757

Mailing address

311 Autumn Oaks Dr
Baton Rouge, LA 70810-5363
Phone (225) 754-8660

Other names 1

  • Mrs. Therese B Smith Professional name

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
14976LAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1598838245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 AUTUMN OAKS DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708105363",
            "telephone_number": "225-754-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 E HIGHWAY 30",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374757",
            "telephone_number": "225-647-4182",
            "fax_number": "225-644-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "THERESE",
        "middle_name": "BOURGEOIS",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "14976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESE",
            "last_name": "SMITH",
            "middle_name": "B",
            "prefix": "MRS.",
            "credential": "RPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.