NPIMap

Individual provider Active NPI

Thattil Pavunny Gouri, MD

  • Pediatrics Physician
  • New Orleans, LA
National Provider Identifier
1992807812
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
04552R Issued in LA
Practice address
3201 General Meyer Ave
Ste C
New Orleans, LA 70114
Phone
(504) 362-8930
Fax
(504) 362-8486
NPI assigned
Sep 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 04552R LA Primary

Addresses

Primary practice location

3201 General Meyer Ave
Ste C
New Orleans, LA 70114

Mailing address

121 English Turn Dr
Thattil P Gouri MD
New Orleans, LA 79131
Phone (504) 392-2231

Other identifiers 2

IdentifierTypeStateIssuer
1194620MedicaidLA
1942111OtherLACLINIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04552RLAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marillac Community Health Centers Past Accepting new patients
Ascension Depaul Services Past Accepting new patients
Childrens Clinic of New Orleans Pediatrics Past Accepting new patients
Ascension Depaul Services Past Accepting new patients
Marillac Community Health Centers Past Accepting new patients
Marillac Community Health Centers Past Accepting new patients
Marillac Community Health Centers Past Accepting new patients
Ascension Depaul Services Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992807812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 ENGLISH TURN DR",
            "address_2": "THATTIL P GOURI MD",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "79131",
            "telephone_number": "504-392-2231",
            "fax_number": "504-362-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 GENERAL MEYER AVE",
            "address_2": "STE C",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70114",
            "telephone_number": "504-362-8930",
            "fax_number": "504-362-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURI",
        "first_name": "THATTIL",
        "middle_name": "PAVUNNY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "04552R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194620",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC",
            "identifier": "1942111",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.