Individual provider Active NPI

Daphne Lane Nierman

  • Occupational Therapy Assistant
  • Shreveport, LA
National Provider Identifier
1053682120
Registry record updated Jan 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA.Z20578 Issued in LA
Practice address
1723 Bayou Dr
Shreveport, LA 71105-3401
Phone
(318) 751-3484
NPI assigned
Jan 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA.Z20578 LA Primary

Addresses

Primary practice location

1723 Bayou Dr
Shreveport, LA 71105-3401

Mailing address

1723 Bayou Dr
Shreveport, LA 71105-3401

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

State licenses

LicenseStateTypeSpecialty
OTA.Z20578LAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1327190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327190400000",
    "number": "1053682120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 BAYOU DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711053401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 BAYOU DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711053401",
            "telephone_number": "318-751-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIERMAN",
        "first_name": "DAPHNE",
        "middle_name": "LANE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-22",
        "last_updated": "2012-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "LA",
            "license": "OTA.Z20578",
            "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 22, 2012; 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.