Active NPI
Raven Nicole Dugas
- Athletic Trainer
- Alexandria, LA
National Provider Identifier
1174643043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATH.200020
- Practice address
- 3347 Masonic Dr
Alexandria, LA 71301-3842 - Phone
- (318) 664-1579
- NPI assigned
- Apr 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | ATH.200020 | LA | Primary |
Addresses
Primary practice location
3347 Masonic Dr
Alexandria, LA 71301-3842
Mailing address
920 Twin Bridges Rd Apt 74
Alexandria, LA 71303-2072
Phone (225) 810-0108
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
| License | State | Type | Specialty |
|---|---|---|---|
| ATH.200020 | LA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174643043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 TWIN BRIDGES RD APT 74",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713032072",
"telephone_number": "225-810-0108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3347 MASONIC DR",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713013842",
"telephone_number": "318-664-1579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUGAS",
"first_name": "RAVEN",
"middle_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "LA",
"license": "ATH.200020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.