PELICAN MEDICAL, WELLNESS, AND COSMETIC CENTER (NPI# 1356997399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356997399 |
| Entity Type | Organization |
| Organization Name | PELICAN MEDICAL, WELLNESS, AND COSMETIC CENTER |
| Practice Address |
6473 Highway 44 Ste 103 Gonzales LA 70737-8179 |
| Mailing Address |
40230 Pelican Point Pkwy Gonzales LA 70737-8511 |
| Practice Telephone | 2252571040 |
| Practice Fax Number | 2252571043 |
| Mailing Telephone | 2252571040 |
| Mailing Fax Number | 2252571043 |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2019-08-15 |
| Authorized Official Name | MARY MARGARET GAUTREAU (MANAGING MEMBER) |
| Authorized Official Telephone | 2252571040 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WW0101X |
Registered Nurse Specialization: Women's Health Care, Ambulatory |
Nursing Service Providers | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Pelican Medical Wellness and Cosmetic Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497301709 | Pelican Medical, Wellness, and Cosmetic Center | Registered Nurse | 6473 Hwy 44, Unit 103, Gonzales, LA 70737-8158 | 2019-08-13 |
| Street Address |
6473 HIGHWAY 44 STE 103 |
| City | GONZALES |
| State | LA |
| Zip Code | 70737-8179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558602664 | Lindsay Renee Burner | Nurse Practitioner | 6473 Highway 44 Ste 103, Gonzales, LA 70737-8179 | 2013-03-14 |
| 1669028429 | Sarah Elizabeth Lemoine | Registered Nurse | 6473 Highway 44 Ste 103, Gonzales, LA 70737-8179 | 2019-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461593 | Scott G Petrie Md Apmc | Non-Pharmacy Dispensing Site | 1014 West St Clare Boulevard, Ste 1020, Gonzales, LA 70737 | 2020-09-15 |
| 1407461981 | Bryant Louis Bourgeois | Dentist | 13317 N Burnside, Gonzales, LA 70737 | 2020-09-11 |
| 1821612631 | Kene Anje Hamilton | Behavioral Analyst | 1028 East Worthy Street, Gonzales, LA 70737 | 2020-06-08 |
| 1801428636 | Mercedes Francis | Behavior Technician | 1023 E W Worthy Rd, Gonzales, LA 70737 | 2020-02-10 |
| 1407347586 | Functional Dme | Prosthetic/Orthotic Supplier | 219 W. Eastbank St., Ste B, Gonzales, LA 70737 | 2018-05-23 |
| 1235631789 | Transporting On Purpose | Non-emergency Medical Transport (VAN) | 42148 Conifer Drive, Gonzales, LA 70737 | 2018-03-01 |
| 1215453121 | Michelle Fuller Harris | Social Worker | 39094 N Angelle Ct, Gonzales, LA 70737 | 2017-08-22 |
| 1215452529 | Lani Litchfield | Specialist/Technologist | 13341 W. Mill Grove Dr, Gonzales, LA 70737 | 2017-08-08 |
| 1326569369 | Tyler Joshua Turner | Counselor | 1923 South Edwards, Gonzales, LA 70737 | 2017-06-29 |
| 1518408046 | Margaret Madere | Social Worker | 2827 S Ruby Street, Gonzales, LA 70737 | 2017-03-16 |
| Find all providers in zip 70737 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184176158 | Gonzales Medical Center, Inc | Clinic/Center | 18 Fourth Street, Gonzales, CA 93926-0808 | 2016-10-26 |
| 1467507913 | Pelican State Outpatient Center - Caro Clinic L. L. C. | Clinic/Center | 2304 S Burnside Ave Ste 2, Gonzales, LA 70737-4664 | 2007-01-24 |
| 1104856913 | Dominador C Gines Jr. | Clinic/Center | 132 Alta Street, Gonzales, CA 93926-3005 | 2006-07-04 |
| 1578885240 | Adult Medicine Institute & Diagnostic Center | Clinic/Center | 1937 S Burnside Ave, Gonzales, LA 70737-4632 | 2010-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205457645 | Perfect Phyzique Wellness & Body Contouring, LLC | Clinic/Center | 220 Carroll St Ste A, Shreveport, LA 71105-4247 | 2020-04-27 |
| 1104445758 | Jennings American Legion Hospital Inc | Clinic/Center | 1322 Elton Rd Ste F, Jennings, LA 70546-4100 | 2020-04-14 |
| 1346874732 | Southeast Family Medical Practice | Clinic/Center | 1320 N Morrison Blvd Ste 125, Hammond, LA 70401-2242 | 2020-02-25 |
| 1356973077 | Phca Houma LLC | Clinic/Center | 435 Corporate Dr Ste 402, Houma, LA 70360-2498 | 2020-02-11 |
| 1124659164 | Diana L. Corley, Fnp, LLC | Clinic/Center | 1015 Hwy 107, Centerpoint, LA 71323 | 2020-01-29 |
| 1790322717 | Take Care Clinic LLC | Clinic/Center | 6721 Saint Claude Ave Ste B, Arabi, LA 70032-1247 | 2019-12-09 |
| 1518503754 | Optimus Primary Care, LLC | Clinic/Center | 13828 Coursey Boulevard, Address Line 2, Baton Rouge, LA 70817 | 2019-11-22 |
| 1992367791 | Family First Medical & Wellness Clinic, LLC | Clinic/Center | 300 Clay St, Kenner, LA 70062 | 2019-07-01 |
| 1366926040 | In and Out Urgent Care Covington, LLC | Clinic/Center | 13130 Hwy 1085, Suite 100, Covington, LA 70433-7829 | 2018-09-19 |
| 1588143556 | Pediatric Center of Many LLC | Clinic/Center | 315 S Highland Dr Ste A, Many, LA 71449-3719 | 2018-08-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.