Organization Active NPI

Sugarland Pediatrics, LLC

  • Pediatrics Physician
  • Houma, LA
National Provider Identifier
1598882151
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
022422 Issued in LA
Legal business name
SUGARLAND PEDIATRICS, LLC
Practice address
5642 W Main St
Houma, LA 70360-1250
Phone
(985) 853-2273
Fax
(985) 853-2790
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gretta Bourgeois
Title
Insurance Manager
Phone
(985) 448-3737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 022422 LA Primary

Addresses

Primary practice location

5642 W Main St
Houma, LA 70360-1250

Mailing address

PO Box 968
Thibodaux, LA 70302-0968
Phone (985) 448-3737

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1055229Sugarland Pediatrics LLC5642 West Main Street, Houma, LA 70360Certificate of waiverSep 16, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598882151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 968",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703020968",
            "telephone_number": "985-448-3737",
            "fax_number": "985-448-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5642 W MAIN ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703601250",
            "telephone_number": "985-853-2273",
            "fax_number": "985-853-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGARLAND PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOURGEOIS",
        "authorized_official_first_name": "GRETTA",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "985-448-3737"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "022422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.