GLENN R LANDRY (NPI# 1609874205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609874205 |
| Entity Type | Individual |
| Full Name | GLENN R LANDRY |
| Credential | M.D. |
| Practice Address |
1111 Medical Center Blvd Suite 313n Marrero LA 70072-3151 |
| Practice Telephone | 5043710071 |
| Practice Fax Number | 5073710272 |
| Mailing Telephone | 5043710071 |
| Mailing Fax Number | 5043710272 |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 011421 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | CIGNA | 4367671004 | 01 |
| LA | AETNA | 1021299 | 01 |
| LA | 1151378 | 05 | |
| LA | UNITED HEALTHCARE | 1900174 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629375712 | Glenn Jerome Landry | Nurse Practitioner | 7777 Hennessy Blvd, Suite 217, Baton Rouge, LA 70808-4300 | 2011-02-25 |
| Street Address |
1111 MEDICAL CENTER BLVD SUITE 313N |
| City | MARRERO |
| State | LA |
| Zip Code | 70072-3151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487657359 | West Jefferson Surgery Center, LLC | Clinic/Center | 1111 Medical Center Blvd, Ste 105n, Marrero, LA 70072-3152 | 2005-05-24 |
| 1972129211 | Marissa Liantonio Miller | Nurse Practitioner | 1111 Medical Center Blvd, Marrero, LA 70072-3151 | 2020-06-23 |
| 1952920324 | Kirstie Rae Schieffler | Physician Assistant | 1111 Medical Center Blvd, Marrero, LA 70072-3151 | 2020-04-15 |
| 1841730918 | Samantha Schenker | Nurse Practitioner | 1111 Medical Center Blvd, N406, Marrero, LA 70072-3151 | 2017-03-08 |
| 1376092379 | Shelli Rodriguez Ergen | Nurse Practitioner | 1111 Medical Center Blvd, Suite South 113, Marrero, LA 70072-3151 | 2016-10-02 |
| 1326418443 | Cain Foot Center, LLC | Podiatrist | 1111 Medical Center Blvd, Suite N-313, Marrero, LA 70072-3151 | 2015-10-01 |
| 1235515693 | Joseph Guarnieri | Eyewear Supplier (Equipment, not the service) | 1111 Medical Center Blvd, Suite N-114, Marrero, LA 70072-3151 | 2015-08-07 |
| 1639552979 | Kelly Thibodeaux | Nurse Practitioner | 1111 Medical Center Blvd, 350s, Marrero, LA 70072-3151 | 2015-07-06 |
| 1629478409 | Ochsner Clinic LLC | General Practice | 1111 Medical Center Blvd, Suite 313n, Marrero, LA 70072-3151 | 2014-08-28 |
| 1285034553 | Raven S Jackson | Pharmacist | 1111 Medical Center Blvd, S 850, Marrero, LA 70072-3151 | 2014-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780232579 | Brittany Inez Young | Technician | 4465 Bay View Drive, Marrero, LA 70072 | 2019-08-27 |
| 1356829774 | Zachary Allen Runge Kleinpeter | Physician Assistant | 1111 Medical Center Blvd Ste S630, Marrero, LA 70072 | 2018-07-30 |
| 1689172611 | Derron White | Specialist | 2324 Barataria Blvd, Marrero, LA 70072 | 2018-01-24 |
| 1477064616 | Bone & Joint, LLC Physical Therapy | Physical Therapist | 4633 Wichers Dr., Marrero, LA 70072 | 2017-10-16 |
| 1477077410 | Darlene Jenkins | Case Manager/Care Coordinator | 7606 Westbank Expy Ste B, Marrero, LA 70072 | 2017-08-01 |
| 1871017186 | Tyra K Haynes | Non-emergency Medical Transport (VAN) | 536 Westwood Drive, Marrero, LA 70072 | 2017-07-28 |
| 1265961536 | Danika Kayelle Frank | Social Worker | 6189 Boutte St, Marrero, LA 70072 | 2017-06-08 |
| 1528596673 | Monica Cheree Mayberry | Counselor | 931 Westwood Dr., Marrero, LA 70072 | 2017-06-01 |
| 1710419197 | Sharla Black | Counselor | 2069 Paine Drive, Marrero, LA 70072 | 2017-04-03 |
| 1699207043 | Tango Austin | Counselor | 2573 Foliage Drive, Marrero, LA 70072 | 2017-04-03 |
| Find all providers in zip 70072 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174966600 | Matthew Donald Strain | Urology | 1111 Medical Center Blvd Ste 650, Marrero, LA 70072 | 2013-04-15 |
| 1649575952 | West Jefferson Specialty Physician Services | Urology | 1111 Medical Center Blvd, Suite N-311, Marrero, LA 70072-3151 | 2011-01-18 |
| 1548497860 | Gregory Paul Larsen | Urology | 1111 Medical Center Blvd, Suite 313, Marrero, LA 70072-3151 | 2009-06-12 |
| 1508080664 | W. Aaron Caraway | Urology | 1111 Medical Center Blvd, Suite 313n, Marrero, LA 70072-3151 | 2007-04-12 |
| 1427078898 | Pablo J Labadie | Urology | 1111 Medical Center Blvd, S-650, Marrero, LA 70072 | 2006-07-20 |
| 1740200229 | New Orleans Urology Specialists, Apmc | Urology | 1111 Medical Center Blvd, Suite N-311, Marrero, LA 70072-3151 | 2006-07-20 |
| 1881660553 | Urologic Institute of New Orleans | Urology | 1111 Medical Center Blvd, Ste 313 N, Marrero, LA 70072-3151 | 2006-02-23 |
| 1720070568 | Wesley W Bryan | Urology | 1111 Medical Center Blvd, Ste. S-650., Marrero, LA 70072-3151 | 2005-08-18 |
| 1174522577 | Jon Ryan Glass | Urology | 1111 Medical Center Blvd, S-650, Marrero, LA 70072-3151 | 2005-07-18 |
| 1336147008 | Jules S Deutsch | Urology | 1111 Medical Center Blvd, Suite 313n, Marrero, LA 70072-3151 | 2005-07-07 |
| Find all providers in MARRERO | ||||
Please comment or provide details below to improve the information on GLENN R LANDRY.
| 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.