NPIMap

Individual provider Active NPI

Jon Guidry, MD

  • Psychiatry Physician
  • Tyler, TX
National Provider Identifier
1942384276
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
J2879 Issued in TX
Practice address
11937 US Highway 271
Tyler, TX 75708-3154
Phone
(903) 683-3421
NPI assigned
Oct 24, 2006
Last updated
Feb 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X J2879 TX Primary

Addresses

Primary practice location

11937 US Highway 271
Tyler, TX 75708-3154

Mailing address

PO Box 731912
Dallas, TX 75373-1912
Phone (903) 877-7777

Other identifiers 1

IdentifierTypeStateIssuer
116320603MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040805001524 TX Practitioner - Psychiatry 6002887643 Reassigns benefits to 1 organization
I20230526000064 LA Practitioner - Psychiatry 6002887643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical Branch at Galveston, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Area Psychiatry LLCGroup PAC ID 7810938321, 13 clinicians

Practice addresses (Care Compare)

401 Dr Michael Debakey Dr
Suite 301
Lake Charles, LA 70601

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J2879TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Area Psychiatry LLC Psychiatry CurrentSince Apr 1, 2023 Accepting new patients
Health and Human Services Commission Psychiatry Current Accepting new patients
Anderson Cherokee Community Enrichment Services Psychiatry Current Accepting new patients
Health and Human Services Commission CurrentSince Sep 1, 2017 Accepting new patients
The Gulf Coast Center Psychiatry PastSince Apr 9, 2009 Accepting new patients
Christus Health Southwestern Louisiana Past Accepting new patients
Utmb Faculty Group Practice Psychiatry Past Accepting new patients
Allyson Warshaw, LCSW LLC Past Accepting new patients

Locations

333 Dr Michael Debakey Dr
Ste 220
Lake Charles, LA 70601
Phone (337) 478-9828

401 Dr Michael Debakey Dr
Ste 301
Lake Charles, LA 70601

1011 College Ave
Jacksonville, TX 75766
Phone (903) 541-2577

3320 S Loop 256
Palestine, TX 75801
Phone (903) 723-6136

805 N Dickinson Dr
Rusk, TX 75785
Phone (903) 683-7201

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1942384276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731912",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731912",
            "telephone_number": "903-877-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154",
            "telephone_number": "903-683-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIDRY",
        "first_name": "JON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "J2879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116320603",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.