Active NPI
Tora Bourgeois, RSW
- Case Manager/Care Coordinator
- Mandeville, LA
National Provider Identifier
1730847138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 16418
- Practice address
- 820 Asbury Dr
Mandeville, LA 70471-1842 - Phone
- (985) 674-5155
- Fax
- (985) 674-5156
- NPI assigned
- Dec 2, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 16418 | LA | |
| Case Manager/Care Coordinator | 171M00000X | 16418 | LA | Primary |
Addresses
Primary practice location
820 Asbury Dr
Mandeville, LA 70471-1842
Mailing address
820 Asbury Dr
Mandeville, LA 70471-1842
Phone (985) 674-5155
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16418 | LA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693353600000",
"number": "1730847138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 ASBURY DR",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704711842",
"telephone_number": "985-674-5155",
"fax_number": "985-674-5156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 ASBURY DR",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704711842",
"telephone_number": "985-674-5155",
"fax_number": "985-674-5156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURGEOIS",
"first_name": "TORA",
"credential": "RSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-02",
"last_updated": "2023-08-30",
"certification_date": "2023-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "LA",
"license": "16418",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "LA",
"license": "16418",
"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 Aug 30, 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.