Individual provider Active NPI

Stephanie Louise Gravois-Rupe, M.D.

  • Child & Adolescent Psychiatry Physician
  • New Orleans, LA
National Provider Identifier
1891915468
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
026085 Issued in LA
Practice address
1440 Canal St
New Orleans, LA 70112-2703
Phone
(504) 988-7829
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 026085 LA Primary

Addresses

Primary practice location

1440 Canal St
New Orleans, LA 70112-2703

Mailing address

905 Old Metairie PL
Metairie, LA 70001-6085
Phone (504) 234-8513

Other identifiers 3

IdentifierTypeStateIssuer
026085OtherLASTATE LICENSE NUMBER
31366OtherLASTATE CDS NUMBER
1055131MedicaidLA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211020000561 LA Practitioner - Psychiatry 7012305394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Central la Human Services AuthorityGroup PAC ID 7810129871, 50 clinicians

Practice addresses (Care Compare)

5599 Hwy 311
Houma, LA 70360-2866
Phone (985) 857-3615

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
026085LAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central la Human Services Authority CurrentSince Oct 5, 2021 Accepting new patients
South Central la Human Services Authority Current Accepting new patients

Locations

5599 Highway 311
Houma, LA 70360
Phone (985) 857-3615

805 Barrow St
Houma, LA 70360
Phone (985) 857-3615

158 Regal Row
Houma, LA 70360
Phone (985) 876-8889

1809 W Airline Hwy
La Place, LA 70068
Phone (985) 652-8444

500 Roderick St
Ste B
Morgan City, LA 70380
Phone (985) 380-2460

157 Twin Oaks Dr
Raceland, LA 70394
Phone (985) 537-6823

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJJCA

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.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1891915468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 OLD METAIRIE PL",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700016085",
            "telephone_number": "504-234-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 CANAL ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122703",
            "telephone_number": "504-988-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVOIS-RUPE",
        "first_name": "STEPHANIE",
        "middle_name": "LOUISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "LA",
            "license": "026085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "026085",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CDS NUMBER",
            "identifier": "31366",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1055131",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.