Clint C Guillory, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

015565 Issued in LA

Practice address

2408 Broadmoor Boulevard
Suite 2
Monroe, LA 71201

Phone

(318) 807-7875

Fax

(318) 812-9997

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

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 and National Provider Directory roles.

• Affinity Health Group, LLC

  • Family Medicine Physician
  • Monroe, LA
  • NPI 1023291226
  Medicare reassignment
• Affinity Health Group, LLC

  • Family Medicine Physician
  • Mangham, LA
  • NPI 1902850035
  NPD
• Christus Health Central Louisiana

  • General Acute Care Hospital
  • Alexandria, LA
  • NPI 1639160799
  NPD (past)
• SFN Professional Management

  • Registered Nurse
  • Monroe, LA
  • NPI 1285681049
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1891852984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DESIARD STREET",
            "address_2": "SUITE 355",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71201",
            "telephone_number": "318-807-7875",
            "fax_number": "318-812-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 BROADMOOR BOULEVARD",
            "address_2": "SUITE 2",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71201",
            "telephone_number": "318-807-7875",
            "fax_number": "318-812-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLORY",
        "first_name": "CLINT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "015565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1397261",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1351199",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guidance Personal Care LLC
• Guidance Personal Care LLC
• Hannah Guilbeau
• Jennifer Guill
• Gerline Guillaume
• John Toben Guillory, OT
• Guillory'S Therapy Clinic, Inc.
• Jamie Lynn Putnam Guillot, ACNPC-AG
• Mallorie Guillot
• Thomas Andrew Gulick, M.D.

• Family Medicine Physician in Monroe, LA
• Providers in Monroe, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; 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.