Primary Care at Home of Louisiana, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

PRIMARY CARE AT HOME OF LOUISIANA, LLC

Practice address

6425 Youree Dr Ste 290
One Bellemead Center
Shreveport, LA 71105-4634

Phone

(318) 219-9549

Fax

(318) 219-3211

NPI assigned

Sep 6, 2016

Organization subpart

No

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

Authorized official

Name

Donald D. Stelly

Title

President

Phone

(337) 233-1307

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473120000000",
    "number": "1023565298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 YOUREE DR STE 290",
            "address_2": "ONE BELLEMEAD CENTER",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054634",
            "telephone_number": "318-219-9549",
            "fax_number": "318-219-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE AT HOME OF LOUISIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-06",
        "status": "A",
        "authorized_official_last_name": "STELLY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Caudle Price, MSN, AGNP-C
• Carolyn Baxter Priddy, RN
• Phillip M Priddy, CRNA
• Pride Patient Transportation,LLC
• Lashunda Prim
• Prime Source Medical Services, Inc
• Jennifer Prime, MD
• Jeremy Paul Prime, CRNA
• Jill Richie Prime, CRNA
• Brian C Primeaux

• Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.