Individual provider Active NPI

Carleigh Raeanna Cavanaugh

  • Student in an Organized Health Care Education/Training Program
  • Mandeville, LA
National Provider Identifier
1053028860
Registry record updated Sep 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1620 Clausel St
Mandeville, LA 70448-2204
Phone
(985) 377-5956
NPI assigned
Nov 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1620 Clausel St
Mandeville, LA 70448-2204

Mailing address

1620 Clausel St
Mandeville, LA 70448-2204
Phone (198) 537-7595

Other practice location 1

1620 Clausel St
Mandeville, LA 70448-2204
Phone (985) 377-5956

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

NPI Registry JSON

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696032000000",
    "number": "1053028860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 CLAUSEL ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704482204",
            "telephone_number": "198-537-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 CLAUSEL ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704482204",
            "telephone_number": "985-377-5956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 Clausel St",
            "address_purpose": "LOCATION",
            "city": "Mandeville",
            "state": "LA",
            "postal_code": "704482204",
            "country_code": "US",
            "telephone_number": "985-377-5956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "CARLEIGH",
        "middle_name": "RAEANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2023-09-30",
        "certification_date": "2023-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.