Individual provider Active NPI

William Patrick Gahan, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Baton Rouge, LA
National Provider Identifier
1720088529
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
04634R Issued in LA
Practice address
5247 Didesse Dr
Baton Rouge, LA 70808-9153
Phone
(225) 765-3076
Fax
(225) 765-3090
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 04634R LA Primary

Addresses

Primary practice location

5247 Didesse Dr
Baton Rouge, LA 70808-9153

Mailing address

5247 Didesse Dr
Baton Rouge, LA 70808-9153
Phone (225) 765-3076

Other identifiers 2

IdentifierTypeStateIssuer
1196550MedicaidLA
380001857OtherLARAILROAD MEDICARE

Other names 1

  • Dr. W Patrick Gahan Other name

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11115LAMDProfessional Counselor
04634RLAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Hospital Inc Geriatric Medicine Past Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients
Our Lake of the Lake Hospital Inc Past Accepting new patients
Our Lady of the Lake Hospital Inc Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1720088529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5247 DIDESSE DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089153",
            "telephone_number": "225-765-3076",
            "fax_number": "225-765-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5247 DIDESSE DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089153",
            "telephone_number": "225-765-3076",
            "fax_number": "225-765-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAHAN",
        "first_name": "WILLIAM",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "LA",
            "license": "04634R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1196550",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "380001857",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "W",
            "last_name": "GAHAN",
            "middle_name": "PATRICK",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Mar 27, 2015; 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.