VA Diabetic Foot Source LLC

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

Organization subpart

No

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

Authorized official

Name

Mr. Victor V Manning, RN

Title

Owner

Phone

(318) 560-2700

Specialties & licenses 1

Addresses

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": []
}

• Urgentems
• Amanda Jean Urquhart, PTA
• Susonne Annette Ursin, M.D.
• Philip Andrew Utter, M.D.
• Ahmad Uwais
• Jaimie Marie Vacha, PT
• Fnu Vaibhav
• Shruti Vaidyanathan
• Prafulchandra G Vakil, MBBS MD
• Akhila Vala, MD

• Nursing Care Agency in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Nursing Care Agency in Louisiana

• 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.