Individual provider Active NPI

Courtney Lynn Gauthreaux, MD

  • Pediatrics Physician
  • La Place, LA
National Provider Identifier
1992332548
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
331356 Issued in LA
Practice address
451 Rue de Sante
La Place, LA 70068-5462
Phone
(985) 652-4400
Fax
(985) 652-4490
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 331356 LA Primary

Addresses

Primary practice location

451 Rue de Sante
La Place, LA 70068-5462

Mailing address

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 899-9511

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231026000962 LA Practitioner - Pediatric Medicine 3971959008 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
331356LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Medical Practice Corporation Pediatrics CurrentSince Aug 1, 2023 Accepting new patients

Locations

141 Ormond Center Ct
Destrehan, LA 70047
Phone (985) 764-7337

451 Rue de Sante
La Place, LA 70068
Phone (985) 652-4400

3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880

1100 Poydras St
Ste 2500
New Orleans, LA 70163
Phone (504) 527-9953

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1992332548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-899-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 RUE DE SANTE",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700685462",
            "telephone_number": "985-652-4400",
            "fax_number": "985-652-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTHREAUX",
        "first_name": "COURTNEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "331356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Place, LA

Sources for this page

Verify at the official NPI Registry.