Active NPI
Deirdre Mashale Wright
- Prosthetist
- Shreveport, LA
National Provider Identifier
1013669571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- Practice address
- 410 Gravois Dr
Shreveport, LA 71106-6902 - Phone
- (318) 505-1425
- NPI assigned
- Jan 25, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetist | 224P00000X | Primary |
Addresses
Primary practice location
410 Gravois Dr
Shreveport, LA 71106-6902
Mailing address
410 Gravois Dr
Shreveport, LA 71106-6902
Phone (318) 505-1425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boogey Make-Up Studio Hair Loss Specialist | Prosthetist | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Shreveport, LA
- NPI 1730940842
Prosthetist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643068800000",
"number": "1013669571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 GRAVOIS DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711066902",
"telephone_number": "318-505-1425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 GRAVOIS DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711066902",
"telephone_number": "318-505-1425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRIGHT",
"first_name": "DEIRDRE",
"middle_name": "MASHALE",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-25",
"last_updated": "2022-01-25",
"certification_date": "2022-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": null,
"license": null,
"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 Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.