NPIMap

Individual provider Active NPI

Mary Debrueys, M.C.D.

  • Speech-Language Pathologist
  • Baton Rouge, LA
National Provider Identifier
1710262555
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
636 Issued in LA
Practice address
3631 S Lakeshore Dr
Baton Rouge, LA 70808-3631
Phone
(225) 388-9822
NPI assigned
Oct 12, 2011
Last updated
Oct 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 636 LA
Speech-Language Pathologist 235Z00000X 636 LA Primary

Addresses

Primary practice location

3631 S Lakeshore Dr
Baton Rouge, LA 70808-3631

Mailing address

3631 S Lakeshore Dr
Baton Rouge, LA 70808-3631

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
636LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Peer Plus, LLC Multi-Specialty Past Accepting new patients

Organizations & group practices 1

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": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1710262555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3631 S LAKESHORE DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708083631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 S LAKESHORE DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708083631",
            "telephone_number": "225-388-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBRUEYS",
        "first_name": "MARY",
        "credential": "M.C.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "LA",
            "license": "636",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.