Individual provider Active NPI

Gary Bryan Fillette, M.D.

  • Psychiatry Physician
  • Pineville, LA
National Provider Identifier
1639490154
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
303848 Issued in LA
Practice address
242 W Shamrock Ave Unit 1
Pineville, LA 71360-6439
Phone
(318) 484-6850
NPI assigned
Jun 18, 2010
Last updated
Nov 16, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 303848 LA Primary

Addresses

Primary practice location

242 W Shamrock Ave Unit 1
Pineville, LA 71360-6439

Mailing address

4501 Jackson St Ext Ste C
Alexandria, LA 71303-2555
Phone (318) 484-6850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170104001615 LA Practitioner - Psychiatry 4789804303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Baylor College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

105 Belview Rd
Leesville, LA 71446-2902
Phone (337) 238-6431

5411 Coliseum Blvd
Alexandria, LA 71303-3729
Phone (318) 484-6850

694 Government St
Marksville, LA 71351-2945
Phone (318) 253-9638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Central la Human Services District CurrentSince Nov 28, 2016 Accepting new patients
Central la Human Services District CurrentSince Nov 28, 2016 Accepting new patients

Locations

5411 Coliseum Blvd
Alexandria, LA 71303
Phone (318) 484-2347

2801 Fourth St
Ste 5
Jonesville, LA 71343
Phone (318) 339-8553

105 Belview Rd
Leesville, LA 71446
Phone (337) 238-6431

694 Government St
Marksville, LA 71351
Phone (318) 253-9638

242 W Shamrock Ave
Unit 1
Pineville, LA 71360
Phone (318) 484-6850

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1639490154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 JACKSON ST EXT STE C",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032555",
            "telephone_number": "318-484-6850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 W SHAMROCK AVE UNIT 1",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713606439",
            "telephone_number": "318-484-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLETTE",
        "first_name": "GARY",
        "middle_name": "BRYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "303848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, LA

Sources for this page

Verify at the official NPI Registry.