Gulf Coast Nephrology, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

GULF COAST NEPHROLOGY, LLC

Practice address

300 18TH St Ste 200
Lake Charles, LA 70601-7342

Phone

(337) 497-0366

Fax

(337) 497-1367

NPI assigned

May 5, 2022

Organization subpart

No

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

Authorized official

Name

Diana Del Toro

Title

Officer of the Company

Phone

(337) 288-5557

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anthony Paul Blalock, M.D.

  • Nephrology Physician
  • Lafayette, LA
  • NPI 1124037726
  Medicare reassignment Care Compare group NPD
• Roderick V. Clark, M.D.

  • Nephrology Physician
  • Lafayette, LA
  • NPI 1225066939
  Medicare reassignment Care Compare group NPD
• Asif Nisar, MD

  • Nephrology Physician
  • Lake Charles, LA
  • NPI 1316911092
  Medicare reassignment Care Compare group NPD
• Shivakanth Burugu, M.D.

  • Nephrology Physician
  • New Iberia, LA
  • NPI 1023334828
  Medicare reassignment NPD
• Spencer T Hatch, DO

  • Nephrology Physician
  • Lafayette, LA
  • NPI 1518321496
  Medicare reassignment NPD
• Juan Carlos Zeik, M.D.

  • Nephrology Physician
  • Lafayette, LA
  • NPI 1275569485
  Medicare reassignment NPD

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1982340774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W SAINT MARY BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064638",
            "telephone_number": "337-288-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 18TH ST STE 200",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017342",
            "telephone_number": "337-497-0366",
            "fax_number": "337-497-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST NEPHROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "DEL TORO",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OFFICER OF THE COMPANY",
        "authorized_official_telephone_number": "337-288-5557"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2602616",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanya L Guillory
• Warrie Latrice Guillory
• Guillorys Transportation LLC
• Hayley Michelle Guinn
• Gulf Coast Behavior Services LLC
• Gulf Coast Psychiatry Services, LLC
• Gulf Coast Radiology LLC
• Gulf Coast Teaching Family Service, Inc. (Gulf Coast Social Services)
• Gulf Coast Teaching Family Services, Inc. (Gulf Coast Social Services, Inc.)
• Gulf Coast Teaching Family Services, Inc. (Gulf Coast Social Services, Inc.)

• Nephrology Physician in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Nephrology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.