NPIMap

Organization Active NPI

VA Diabetic Foot Source LLC

  • Nursing Care Agency
  • Shreveport, LA
National Provider Identifier
1003139619
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
RN121799 Issued in LA
Legal business name
VA DIABETIC FOOT SOURCE LLC
Practice address
9414 Ashmont St
Shreveport, LA 71129-4830
Phone
(318) 560-2700
NPI assigned
Mar 10, 2010
Last updated
Mar 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Authorized official

Name
Mr. Victor V Manning, RNNPI 1992953343
Title
Owner
Phone
(318) 560-2700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X RN121799 LA Primary

Addresses

Primary practice location

9414 Ashmont St
Shreveport, LA 71129-4830

Mailing address

9414 Ashmont St
Shreveport, LA 71129-4830
Phone (318) 560-2700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1003139619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9414 ASHMONT ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711294830",
            "telephone_number": "318-560-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9414 ASHMONT ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711294830",
            "telephone_number": "318-560-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA DIABETIC FOOT SOURCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2010-03-10",
        "status": "A",
        "authorized_official_last_name": "MANNING",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-560-2700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "LA",
            "license": "RN121799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.