Individual provider Active NPI

Donna Marie Gauthreaux, O.D.

  • Optometrist
  • Lafayette, LA
National Provider Identifier
1801989579
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1375507T Issued in LA
Practice address
3505 Ambassador Caffery Pkwy
Lafayette, LA 70503-5130
Phone
(337) 984-1488
Fax
(337) 984-8412
NPI assigned
Oct 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1375507T LA Primary

Addresses

Primary practice location

3505 Ambassador Caffery Pkwy
Lafayette, LA 70503-5130

Mailing address

107 Lafourche St
Donaldsonville, LA 70346-2423
Phone (225) 252-8217

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040406001084 LA Practitioner - Optometry 5395738249 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1375507TLAMDOptometrist

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801989579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 LAFOURCHE ST",
            "city": "DONALDSONVILLE",
            "state": "LA",
            "postal_code": "703462423",
            "telephone_number": "225-252-8217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705035130",
            "telephone_number": "337-984-1488",
            "fax_number": "337-984-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTHREAUX",
        "first_name": "DONNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1375507T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.