Mary Susan Anders, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

230250 Issued in LA

Practice address

8932 Jewella Ave
Shreveport, LA 71118-2117

Phone

(318) 219-4167

NPI assigned

Jul 21, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Susan Brinegar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1013697333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 PARKWAY CIR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711123740",
            "telephone_number": "318-393-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8932 JEWELLA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182117",
            "telephone_number": "318-219-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERS",
        "first_name": "MARY",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "LA",
            "license": "230250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BRINEGAR",
            "middle_name": "SUSAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ananias Incorporated
• Anil Ananthaneni
• Crystal Jasmin Anchondo, APRN, FNP-C
• Caitlyn Anders, LMSW
• Caleb Daniel Anders, PST.023506
• Adrian Dewayne Anderson
• Cassandra D'Wana Anderson
• Erica Anderson, M.A.
• Erica Wiggins Anderson
• Heather K Anderson, SLP

• Licensed Practical Nurse in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Licensed Practical Nurse in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.