Active NPI
Mary Beth Gaudin, CANP
- Primary Care Nurse Practitioner
- Hammond, LA
National Provider Identifier
1659300143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- AP03655
- Practice address
- 42388 Pelican Professional Park
Hammond, LA 70403 - Phone
- (985) 542-6251
- NPI assigned
- Jun 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | AP03655 | LA | Primary |
Addresses
Primary practice location
42388 Pelican Professional Park
Hammond, LA 70403
Mailing address
167 South Gate
Ponchatoula, LA 70454
Phone (985) 542-6251
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP03655 | Other | LA | STATE LICENSE # |
| 30051 | Other | LA | LA CONTROL # |
| 1495948 | Medicaid | LA |
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)
- Enrolled
- Credentials
- Certified Adult Nurse Practitioner, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Internal Medicine Clinic of Tangipahoa, LLC | Primary Care | Past | Accepting new patients |
| Louisiana Hyperbarics | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DHBICA
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Hammond, LA
- NPI 1588678494
Primary Care
-
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- Hammond, LA
- NPI 1487002150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1659300143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "167 SOUTH GATE",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "70454",
"telephone_number": "985-542-6251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42388 PELICAN PROFESSIONAL PARK",
"city": "HAMMOND",
"state": "LA",
"postal_code": "70403",
"telephone_number": "985-542-6251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUDIN",
"first_name": "MARY",
"middle_name": "BETH",
"credential": "CANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "LA",
"license": "AP03655",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE #",
"identifier": "AP03655",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LA CONTROL #",
"identifier": "30051",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1495948",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hammond, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.