Active NPI
Mendy Wiltshire
- Family Nurse Practitioner
- Winnsboro, LA
National Provider Identifier
1184054629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F0613348
- Practice address
- 2106 Loop Rd
#A
Winnsboro, LA 71295-3344 - Phone
- (318) 435-6363
- Fax
- (318) 435-4646
- NPI assigned
- Nov 20, 2013
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F0613348 | LA | Primary |
Addresses
Primary practice location
2106 Loop Rd
#A
Winnsboro, LA 71295-3344
Mailing address
PO Box 283
Baskin, LA 71219-0283
Phone (318) 439-0365
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 |
|---|---|---|---|
| F0613348 | LA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384905600000",
"number": "1184054629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 283",
"city": "BASKIN",
"state": "LA",
"postal_code": "712190283",
"telephone_number": "318-439-0365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2106 LOOP RD",
"address_2": "#A",
"city": "WINNSBORO",
"state": "LA",
"postal_code": "712953344",
"telephone_number": "318-435-6363",
"fax_number": "318-435-4646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILTSHIRE",
"first_name": "MENDY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-20",
"last_updated": "2013-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "F0613348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winnsboro, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.