NPIMap

Individual provider Active NPI

Gayle Elliott, FNP

  • Family Nurse Practitioner
  • Pineville, LA
National Provider Identifier
1861988537
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP10054 Issued in LA
Practice address
308 Griffith St
Pineville, LA 71360-5270
Phone
(318) 528-5000
Fax
(318) 448-8013
NPI assigned
Jul 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP10054 LA Primary

Addresses

Primary practice location

308 Griffith St
Pineville, LA 71360-5270

Mailing address

2900 Saint Michael Dr Ste 401
Texarkana, TX 75503-5211
Phone (903) 614-5367

Other practice location 1

641 Rowena Street
Montgomery, LA 71454
Phone (318) 646-3000

Other identifiers 1

IdentifierTypeStateIssuer
2483561MedicaidLA

Other names 1

  • N/a N/a Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180829001699 LA Practitioner - Nurse Practitioner 2365792116 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

3000 S Macarthur Dr
Christus Comm Clinic Alexandria
Alexandria, LA 71301-2927
Phone (318) 448-6800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP10054LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
C H Wilkinson Physician Network Nurse Practitioner CurrentSince Oct 15, 2018 Accepting new patients
C H Wilkinson Physician Network CurrentSince Oct 15, 2018 Accepting new patients
Trinity Clinic Past Accepting new patients

Locations

3000 S MacArthur Dr
Alexandria, LA 71301
Phone (318) 448-6800

308 Griffith St
Pineville, LA 71360
Phone (318) 528-5000

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

2900 Saint Michael Dr
Ste 401
Texarkana, TX 75503
Phone (903) 614-5353

Interoperability endpoints

  • Direct secure messaging: gelliott420121@christushealth.direct-ci.net
  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1861988537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 SAINT MICHAEL DR STE 401",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755035211",
            "telephone_number": "903-614-5367",
            "fax_number": "903-614-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 GRIFFITH ST",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713605270",
            "telephone_number": "318-528-5000",
            "fax_number": "318-448-8013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "641 Rowena Street",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "LA",
            "postal_code": "71454",
            "country_code": "US",
            "telephone_number": "318-646-3000",
            "fax_number": "318-646-3003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "GAYLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP10054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2483561",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pineville, LA

Sources for this page

Verify at the official NPI Registry.