Individual provider Active NPI

Valencia Douglas

  • Community Health Worker
  • Violet, LA
National Provider Identifier
1184082299
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
5636 E Judge Perez Dr Ste F
Violet, LA 70092-2946
Phone
(504) 708-9431
NPI assigned
Feb 3, 2016
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X NU Primary

Addresses

Primary practice location

5636 E Judge Perez Dr Ste F
Violet, LA 70092-2946

Mailing address

2208 Munster Blvd
Meraux, LA 70075-2410
Phone (504) 708-9431

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

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Transportation LLC CurrentSince Oct 8, 2023 Accepting new patients
Faith Pca Services LLC CurrentSince Oct 8, 2023 Accepting new patients
Serenity Outreach Center, LLC Mental Health Past Accepting new patients

Locations

5636 E Judge Perez Dr
Ste F
Violet, LA 70092
Phone (504) 581-8945

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": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1184082299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 MUNSTER BLVD",
            "city": "MERAUX",
            "state": "LA",
            "postal_code": "700752410",
            "telephone_number": "504-708-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5636 E JUDGE PEREZ DR STE F",
            "city": "VIOLET",
            "state": "LA",
            "postal_code": "700922946",
            "telephone_number": "504-708-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "VALENCIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Violet, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.