Katherine Louise Gandert

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301507024 Issued in MI

Practice address

4740 S I 10 Service Rd W Ste 120
Metairie, LA 70001-1214

Phone

(504) 988-5458

Fax

(504) 988-6808

NPI assigned

Mar 19, 2018

Last updated

Nov 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Katherine Louise Gandert Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Promedica Monroe Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1194078055

  MI

  Medicare reassignment NPD
• University Healthcare System, L.C.

  dba LCMC Health Pharmacy Services-Lakeside

  • Community/Retail Pharmacy
  • Metairie, LA
  • NPI 1619446580
  NPD (past)
• Mercy Memorial Hospital Corporatio

  dba Promedica Monroe Regional Hospital

  • General Acute Care Hospital
  • Monroe, MI
  • NPI 1811097223
  NPD (past)

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1811491582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 S I 10 SERVICE RD W STE 120",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011214",
            "telephone_number": "504-988-5458",
            "fax_number": "504-988-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 S I 10 SERVICE RD W STE 120",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011214",
            "telephone_number": "504-988-5458",
            "fax_number": "504-988-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDERT",
        "first_name": "KATHERINE",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2023-11-03",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301507024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgandert247942@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "GANDERT",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Gallo
• Kevin Thomas Galmon
• Cecilia Tolo Gambala, M.D.
• David Gambel, ATC
• Lesa G Gamble
• Benjamin Gandolfi
• Rashanda Makala Gant
• Byron Charles Ganucheau, D.D.S.
• Paul E Ganucheau, D.D.S.
• Brittany Garay, CCC-SLP

• Pediatrics Physician in Metairie, LA
• Providers in Metairie, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.