Active NPI
Bernard Anthony Gaudin, PNP
- Pediatric Nurse Practitioner
- Thibodaux, LA
National Provider Identifier
1891704185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 39280 1810
- Practice address
- 604 N Acadia Rd Ste 200
Thibodaux, LA 70301-4897 - Phone
- (985) 448-3700
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 39280 1810 | LA | Primary |
Addresses
Primary practice location
604 N Acadia Rd Ste 200
Thibodaux, LA 70301-4897
Mailing address
604 N Acadia Rd Ste 200
Thibodaux, LA 70301-4897
Phone (985) 448-3700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1993735 | 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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39280 1810 | LA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Hospital Medical Practice Corporation | Pediatrics | Past | Accepting new patients |
| The Center for Pediatric and Adolescent Medicine,LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatrics Physician
- New Orleans, LA
- NPI 1821090713
-
- Pediatric Adolescent Medicine Physician
- Thibodaux, LA
- NPI 1407858566
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456272000000",
"number": "1891704185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 N ACADIA RD STE 200",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703014897",
"telephone_number": "985-448-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 N ACADIA RD STE 200",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703014897",
"telephone_number": "985-448-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUDIN",
"first_name": "BERNARD",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2016-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "LA",
"license": "39280 1810",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1993735",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Thibodaux, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.