Individual provider Active NPI

Joey Adam Guillory, PA-C

  • Physician Assistant
  • Lafayette, LA
National Provider Identifier
1902209554
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.200741 Issued in LA
Practice address
105 Patriot St
Ste 101
Lafayette, LA 70508-6831
Phone
(337) 534-0653
NPI assigned
Sep 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.200741 LA Primary

Addresses

Primary practice location

105 Patriot St
Ste 101
Lafayette, LA 70508-6831

Mailing address

105 Patriot St
Ste 101
Lafayette, LA 70508-6831
Phone (318) 201-5639

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141224000479 LA Practitioner - Physician Assistant 9436472438 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes After Hours LLC CurrentSince Jul 31, 2018 Accepting new patients

Locations

3824 NE Evangeline Thruway
Carencro, LA 70520
Phone (337) 565-2675

Organizations & group practices 10

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 2

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisiana Orthopaedic Specialists LLC 71 clinicians

Practice addresses (Care Compare)

108 Rue Louis Xiv
Lafayette, LA 70508-5739
Phone (337) 235-8007

Hospital & facility affiliations

  • Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
  • Park Place Surgical Hospital Hospital, Lafayette, LA, CCN 190255

NPI Registry JSON

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1902209554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PATRIOT ST",
            "address_2": "STE 101",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086831",
            "telephone_number": "318-201-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PATRIOT ST",
            "address_2": "STE 101",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086831",
            "telephone_number": "337-534-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLORY",
        "first_name": "JOEY",
        "middle_name": "ADAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-26",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.