C V GUILLERMO JR A PROFESSIONAL MEDICAL CORP (NPI# 1417085143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417085143 |
| Entity Type | Organization |
| Organization Name | C V GUILLERMO JR A PROFESSIONAL MEDICAL CORP |
| Practice Address |
4912 Highway 1 Raceland LA 70394 |
| Mailing Address |
Po Box 390 Raceland LA 70394 |
| Practice Telephone | 9855325092 |
| Practice Fax Number | 9855328044 |
| Mailing Telephone | 9855325092 |
| Mailing Fax Number | 9855328044 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CLAUDIO V GUILLERMO JR. (PRESIDENT) |
| Authorized Official Telephone | 9855325092 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 03719R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1124087 | 05 | |
| LA | BLUE CROSS | 1574214481 | 01 |
| Street Address |
4912 HIGHWAY 1 |
| City | RACELAND |
| State | LA |
| Zip Code | 70394 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053425033 | Savoies Pharmacy | Pharmacy | 4912 Highway 1, Raceland, LA 70394-2559 | 2006-08-18 |
| 1730567256 | Lafourche Medical Group | General Practice | 4912 Highway 1, Raceland, LA 70394-2559 | 2015-05-17 |
| 1164811790 | Lafourche Medical Group LLC | Clinic/Center | 4912 Highway 1, Raceland, LA 70394-2559 | 2015-01-20 |
| 1770917122 | Mary Breaux Rodrigue | Physician Assistant | 4912 Highway 1, Raceland, LA 70394-2559 | 2013-08-21 |
| 1821256686 | Baye Chiropractic Clinic | Chiropractor | 4912 Highway 1, Raceland, LA 70394 | 2008-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598221798 | Caitlin Morris Bacon | Registered Nurse | 4244 Highway 1, Raceland, LA 70394 | 2019-02-13 |
| 1326571597 | Kakeisha Harris | Counselor | 144 Colvan St, Raceland, LA 70394 | 2017-04-05 |
| 1023468774 | Denise Taylor | Counselor | 4075 Hwy 1, Raceland, LA 70394 | 2016-06-14 |
| 1023471133 | Aubrey Orgeron | Psychiatry & Neurology | 111 Twin Oaks Dr., Raceland, LA 70394 | 2016-04-05 |
| 1114383239 | Michelle Rabb | Counselor | 3821 Hwy 1, Raceland, LA 70394 | 2016-01-05 |
| 1508221979 | Renisha Cecilia Oubre | Counselor | 3821 Highway 1, Raceland, LA 70394 | 2015-12-29 |
| 1922463983 | Kiaria Gray | Case Manager/Care Coordinator | 3821 La-1, Raceland, LA 70394 | 2015-12-17 |
| 1285068098 | Don A Falgout | Nurse Anesthetist, Certified Registered | 4608 Hwy 1, Raceland, LA 70394 | 2013-08-28 |
| 1215211933 | Dalton Joseph Boudreaux Jr. | Pharmacist | 4572 Hwy One, Raceland, LA 70394 | 2011-09-29 |
| 1790065746 | Cheri Lasseigne | Chiropractor | 108 Acadia Dr., Raceland, LA 70394 | 2011-08-23 |
| Find all providers in zip 70394 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508049289 | Ochsner Clinic LLC | General Practice | 106 Cypress St, Raceland, LA 70394-2764 | 2007-12-17 |
| 1861681504 | Claudio Verdadero Guillermo Jr. | General Practice | 4912 Hwy. 1, Raceland, LA 70394-0390 | 2007-10-18 |
| 1063611812 | Ochsner Clinic LLC | General Practice | 104 Acadia Drive, Raceland, LA 70394 | 2007-07-12 |
| 1730567256 | Lafourche Medical Group | General Practice | 4912 Highway 1, Raceland, LA 70394-2559 | 2015-05-17 |
| 1699072041 | Ochsner Clinic LLC | General Practice | 141 Twin Oaks Dr, Raceland, LA 70394-2761 | 2011-02-22 |
| 1770894800 | Ochsner Clinic LLC | General Practice | 111 Acadia Park Dr, Raceland, LA 70394-2619 | 2010-06-23 |
| 1578707188 | Ochsner Clinic LLC | General Practice | 4608 Highway 1, Raceland, LA 70394-2623 | 2009-04-27 |
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| 1194205864 | Herbert Gerard Haydel | General Practice | 4412 Elmwood Pkwy, Metairie, LA 70003-2829 | 2018-08-21 |
| 1013493725 | Med-corp Management, L.L.C. | General Practice | 3801 Canal St Ste 100, New Orleans, LA 70119-6043 | 2018-07-16 |
| 1306341060 | Ready Responders Louisiana LLC | General Practice | 1320 Magazine St Ste 203, New Orleans, LA 70130-4267 | 2018-03-26 |
| 1841791415 | Alpha Medical Center, LLC | General Practice | 3648 Pontchartrain Dr Ste 100, Slidell, LA 70458-4816 | 2018-02-28 |
| 1710495627 | Mayfield Advanced Medical, LLC | General Practice | 5419 Jackson St Ext Ste B, Alexandria, LA 71303-2322 | 2018-01-12 |
| 1568976413 | Brandie A Smith | General Practice | 19115 Florida Ave., Suite A, Albany, LA 70711 | 2017-11-29 |
| 1003328444 | Ochsner Clinic LLC | General Practice | 201 Decatur St, New Orleans, LA 70130-1015 | 2017-10-25 |
| 1548790470 | Cure Global, LLC | General Practice | 229 Hidden Pines Dr, Pineville, LA 71360-2203 | 2017-06-13 |
| 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.