Individual provider Active NPI

John Paul Guidry, PT

  • Physical Therapist
  • Mandeville, LA
National Provider Identifier
1679711139
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
07689R Issued in LA
Practice address
5200 Highway 22
Ste 6
Mandeville, LA 70471-2563
Phone
(337) 274-3639
Fax
(985) 792-7685
NPI assigned
Jan 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 07689R LA Primary

Addresses

Primary practice location

5200 Highway 22
Ste 6
Mandeville, LA 70471-2563

Mailing address

5200 Highway 22
Ste 6
Mandeville, LA 70471-2563
Phone (337) 274-3639

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

State licenses

LicenseStateTypeSpecialty
07689RLAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1679711139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 HIGHWAY 22",
            "address_2": "STE 6",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704712563",
            "telephone_number": "337-274-3639",
            "fax_number": "985-792-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HIGHWAY 22",
            "address_2": "STE 6",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704712563",
            "telephone_number": "337-274-3639",
            "fax_number": "985-792-7685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIDRY",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-21",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "07689R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.