Individual provider Active NPI

Gwendolyn Barze, HOME CARE PROVIDER

  • Preferred Provider Organization
  • Harvey, LA
National Provider Identifier
1710100888
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
12053 Issued in LA
Practice address
2245 Manhattan Blvd
Suite 120
Harvey, LA 70058-3580
Phone
(504) 368-5937
Fax
(504) 366-0718
NPI assigned
Apr 10, 2007
Last updated
Oct 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 12053 LA Primary
Preferred Provider Organization 305R00000X 12054 LA

Addresses

Primary practice location

2245 Manhattan Blvd
Suite 120
Harvey, LA 70058-3580

Mailing address

2245 Manhattan Blvd
Suite 120
Harvey, LA 70058-3580
Phone (504) 368-5937

Other identifiers 1

IdentifierTypeStateIssuer
56-2497257MedicaidLA

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12054LAMDPhysical Therapist
12053LAMDPreferred Provider Organization

Organizations & group practices 3

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1710100888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 MANHATTAN BLVD",
            "address_2": "SUITE 120",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700583580",
            "telephone_number": "504-368-5937",
            "fax_number": "504-366-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 MANHATTAN BLVD",
            "address_2": "SUITE 120",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700583580",
            "telephone_number": "504-368-5937",
            "fax_number": "504-366-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARZE",
        "first_name": "GWENDOLYN",
        "name_prefix": "Ms.",
        "credential": "HOME CARE PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "LA",
            "license": "12053",
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "LA",
            "license": "12054",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56-2497257",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; 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.