Active NPI
Brandi Gautreaux, OT
- Occupational Therapist
- Lake Charles, LA
National Provider Identifier
1821216102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTT.Z12103
- Practice address
- 817 Bayou Oak LN
Lake Charles, LA 70605-2629 - Phone
- (337) 274-6744
- NPI assigned
- Apr 23, 2007
- Last updated
- May 24, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTT.Z12103 | LA | Primary |
Addresses
Primary practice location
817 Bayou Oak LN
Lake Charles, LA 70605-2629
Mailing address
817 Bayou Oak LN
Lake Charles, LA 70605-2629
Phone (337) 274-6744
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1068675 | Medicaid | LA |
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 |
|---|---|---|---|
| OTT.Z12103 | LA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337817600000",
"number": "1821216102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 BAYOU OAK LN",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706052629",
"telephone_number": "337-274-6744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "817 BAYOU OAK LN",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706052629",
"telephone_number": "337-274-6744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUTREAUX",
"first_name": "BRANDI",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2012-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "LA",
"license": "OTT.Z12103",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1068675",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
- Gastroenterology Associates of Swla LLC (gi associates)
- Lilian Wanjiku Gathanga, M.S. LPC
- Fralan Todd Gatte, APRN
- Cathy Gauthier
- Haley Margaret Gauthier, LPC
- James Paul Gay, APRN
- Christopher Gean, PT, DPT
- Kayla Fruge Gearen, NP
- Geaux Ptla LLC (Unlimited Performance Physical Therapy)
- Rachel Marie Geerts, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.