Individual provider Active NPI

Damon Cousin Sr.

  • Pharmacist
  • Harvey, LA
National Provider Identifier
1174288021
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15422 Issued in LA
Practice address
2078 Woodmere Blvd
Harvey, LA 70058-2245
Phone
(504) 322-7466
NPI assigned
Nov 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15422 LA Primary

Addresses

Primary practice location

2078 Woodmere Blvd
Harvey, LA 70058-2245

Mailing address

PO Box 2231
Slidell, LA 70459-2231
Phone (985) 445-3154

Other identifiers 1

IdentifierTypeStateIssuer
OTHEROtherLAOTHER

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL other Other
Other URL other Other

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
15422LAMDSchool Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Invision Optical, LLC CurrentSince Nov 9, 2021 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1174288021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2231",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704592231",
            "telephone_number": "985-445-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2078 WOODMERE BLVD",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700582245",
            "telephone_number": "504-322-7466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSIN",
        "first_name": "DAMON",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-05",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "15422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "OTHER",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "other",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "2078 Woodmere Blvd",
            "city": "Harvey",
            "state": "LA",
            "country_code": "US",
            "postal_code": "700582245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "other",
            "affiliation": "N",
            "endpointDescription": "other",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "2078 Woodmere Blvd",
            "city": "Harvey",
            "state": "LA",
            "country_code": "US",
            "postal_code": "700582245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harvey, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.