NPIMap

Organization Active NPI

Paul a Guillory MD a Professional Medical Corporation

  • Otolaryngology Physician
  • Alexandria, LA
National Provider Identifier
1619967254
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
12887 Issued in LA
Legal business name
PAUL A GUILLORY MD A PROFESSIONAL MEDICAL CORPORATION
Practice address
221 Windermere Blvd
Alexandria, LA 71303-3538
Phone
(318) 443-9773
Fax
(318) 443-9779
NPI assigned
Oct 25, 2005
Last updated
Apr 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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

Authorized official

Name
Paul A Guillory, M.D.NPI 1114918281
Title
President
Phone
(318) 443-9773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 12887 LA Primary

Addresses

Primary practice location

221 Windermere Blvd
Alexandria, LA 71303-3538

Mailing address

221 Windermere Blvd
Alexandria, LA 71303-3538
Phone (318) 443-9773

Other identifiers 1

IdentifierTypeStateIssuer
1440108MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121000300 LA Part B Supplier - Clinic/Group Practice 2466354501 Receives reassigned benefits from 2 practitioners
Practice locations: Alexandria, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587081600000",
    "number": "1619967254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 WINDERMERE BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033538",
            "telephone_number": "318-443-9773",
            "fax_number": "318-443-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 WINDERMERE BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033538",
            "telephone_number": "318-443-9773",
            "fax_number": "318-443-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL A GUILLORY MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A",
        "authorized_official_last_name": "GUILLORY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-443-9773",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "12887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1440108",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.