NPIMap

Organization Active NPI

South Louisiana ENT, Facial Plastic & Hair Restoration, Apmc

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Mandeville, LA
National Provider Identifier
1831402924
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
203549 Issued in LA
Legal business name
SOUTH LOUISIANA ENT, FACIAL PLASTIC & HAIR RESTORATION, APMC
Practice address
1420 N Causeway Blvd
Mandeville, LA 70471-3104
Phone
(985) 327-5905
Fax
(985) 200-0840
NPI assigned
Jul 19, 2010
Last updated
Oct 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Authorized official

Name
Jason M Guillot, MDNPI 1912126723
Title
Owner
Phone
(985) 327-5905

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 203549 LA
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 203549 LA Primary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 203549 LA
Sleep Medicine (Otolaryngology) Physician 207YS0012X 203549 LA

Addresses

Primary practice location

1420 N Causeway Blvd
Mandeville, LA 70471-3104

Mailing address

1420 N Causeway Blvd
Mandeville, LA 70471-3104
Phone (985) 327-5905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101108001053 LA Part B Supplier - Clinic/Group Practice 3375738099 Receives reassigned benefits from 12 practitioners
Practice locations: Covington, LA; Hammond, LA; Mandeville, LA; Slidell, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2015769South Louisiana ENT1420 N Causeway Blvd, Mandeville, LA 70471Certificate of waiverNov 2, 2026

National Provider Directory

National Provider Directory

Locations

7043 Highway 190 East Service Rd
Ste C
Covington, LA 70433
Phone (985) 327-5905

1258 Brownswitch Rd
Ste A
Slidell, LA 70461
Phone (985) 327-5905

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760054400000",
    "number": "1831402924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 N CAUSEWAY BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713104",
            "telephone_number": "985-327-5905",
            "fax_number": "985-200-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N CAUSEWAY BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713104",
            "telephone_number": "985-327-5905",
            "fax_number": "985-200-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LOUISIANA ENT, FACIAL PLASTIC & HAIR RESTORATION, APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-19",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A",
        "authorized_official_last_name": "GUILLOT",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-327-5905",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "LA",
            "license": "203549",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "LA",
            "license": "203549",
            "primary": true
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "LA",
            "license": "203549",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "LA",
            "license": "203549",
            "primary": false
        }
    ],
    "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 Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.