Rusty Bourgeois

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

329464 Issued in LA

Practice address

197 Chateau Papillon
Mandeville, LA 70471-8551

Phone

(504) 912-4960

NPI assigned

May 11, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Tallulah, LA
  • NPI 1154852382

  Occupational Therapist

  Medicare reassignment NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1942884408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 CHATEAU PAPILLON",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704718551",
            "telephone_number": "504-912-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 CHATEAU PAPILLON",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704718551",
            "telephone_number": "504-912-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "RUSTY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-11",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "329464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel G. Boudreaux, LCSW
• Tracy Boudreaux, OT
• Kathy Ann Bounds, RN
• Gretchen Smith Bourgeois, SLP
• Juliette Bourgeois, BA - PSYCHOLOGY
• Tora Bourgeois, RSW
• Anna Bove, MD
• Rachael Faith Bowden, LMT
• Michelle M Boze, PSY.D.
• BPC Mandeville

• Occupational Therapist in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Occupational Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.