Jessica Renee Gautreaux, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

MD.202892 Issued in LA

Practice address

200 Henry Clay Ave
New Orleans, LA 70118-5720

Phone

(504) 894-6783

Fax

(504) 894-4150

NPI assigned

Dec 28, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Louisiana State University School of Med in New Orleans Faculty Grou

  dba LSU Healthcare Network

  • Pediatrics Physician
  • New Orleans, LA
  • NPI 1932492626
  Medicare reassignment NPD
• Lsuhsc New Orleans Physicians

  • Pediatrics Physician
  • New Orleans, LA
  • NPI 1447487145
  NPD (past)

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1760666556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-894-9458",
            "fax_number": "504-894-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-894-6783",
            "fax_number": "504-894-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTREAUX",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "LA",
            "license": "MD.202892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005576",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Gaudin, LPN
• Emily Carolyn Gault, MD
• Alisha Marie Gauthier, PHARMD
• Christine Nicolle Gauthier, OTR
• Rochelle Gauthier, LCSW
• Kalyn Marie Gautreaux, MPT
• Raquel Gautreaux, CRNA
• Amanda Gail Gavin
• Emmanuel Kweku Gavua
• Carla Gayle, MD

• Neurology with Special Qualifications in Child Neurology Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.