Paige Cantrell Guillory, MD
Individual provider Active NPI Pediatrics Physician · New Roads, LA
NPI 1912466160 · NPPES record last updated Mar 14, 2023
Key facts
- NPI
- 1912466160
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 330327 (LA)
- Practice address
- 310 Durel Dr
New Roads, LA 70760-2973 - Phone
- (225) 713-2400
- Fax
- (225) 713-2410
- NPI assigned
- Mar 18, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220627001993 | LA | Practitioner - Pediatric Medicine | 2466831136 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 330327 | LA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Our Lady of the Lake Physician Group LLC | Current |
Accepting new patients | |
| Our Lady of the Lake Physician Group LLC | Pediatrics | Current | Accepting new patients |
| Our Lady of the Lake Physician Group, LLC | Current |
Accepting new patients | |
| Woman'S Hospital Foundation | Past | Accepting new patients | |
| Our Lady of the Lake Physician Group LLC | Past | Accepting new patients | |
| Our Lady of the Lake Physician Group LLC | Past | Accepting new patients |
Locations
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011
8300 Constantin Blvd
Baton Rouge, LA 70809
Phone (225) 374-1410
310 Durel Dr
New Roads, LA 70760
Phone (225) 713-2400
Interoperability endpoints
- paige.guillory.1@31704.direct.athenahealth.com
- pcantrell132740@direct.casso.us.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 330327 | LA | Yes |
Addresses
Primary practice location
310 Durel Dr
New Roads, LA 70760-2973
Mailing address
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 713-2405
Other practice location 1
7777 Hennessy Blvd
Baton Rouge, LA 70808-4300
Phone (225) 765-3368
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pcantrell132740@direct.casso.us.com | Direct | |
| FHIR URL | https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Other |
Other providers in New Roads, LA
- Golden Touch Private Care Services LLC
- Misty Barfoot Graning
- Deanderia D Gremillion
- Katie Guedry
- Mary Beth Guerin
- Anne Gustin
- Hanger Prosthetics & Orthotics Inc
- Tonette Harris-Haynes
- Ashley Harrison
- Lauren Hayden
All providers in New Roads, LA · Pediatrics Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.