NPIMap

Organization Active NPI

Sallie Early Healthcare Services

  • Family Medicine Physician
  • Mandeville, LA
National Provider Identifier
1205005097
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
APN0000007667 Issued in TN
Legal business name
SALLIE EARLY HEALTHCARE SERVICES
Practice address
1802 Neva CT
Mandeville, LA 70448-1026
Phone
(865) 588-1584
NPI assigned
Feb 26, 2008
Last updated
Feb 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Sallie Early Tucker, APN
Title
Owner
Phone
(865) 558-1584

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164W00000X APN0000007667 TN
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X APN0000007667 TN Primary

Addresses

Primary practice location

1802 Neva CT
Mandeville, LA 70448-1026

Mailing address

1802 Neva CT
Mandeville, LA 70448-1026
Phone (865) 588-1584

Other identifiers 1

IdentifierTypeStateIssuer
3714700MedicaidTN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1205005097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 NEVA CT",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704481026",
            "telephone_number": "865-588-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 NEVA CT",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704481026",
            "telephone_number": "865-588-1584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLIE EARLY HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "SALLIE",
        "authorized_official_middle_name": "EARLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-558-1584",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "APN0000007667",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "APN0000007667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3714700",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.