Terris Mike

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2219 Claiborne Ave
Shreveport, LA 71103-4301

Phone

(318) 779-0434

NPI assigned

Nov 24, 2015

Last updated

May 29, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1205200557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 KNIGHT ST",
            "address_2": "#434",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052415",
            "telephone_number": "318-631-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 CLAIBORNE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034301",
            "telephone_number": "318-779-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKE",
        "first_name": "TERRIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-24",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1939846",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midsouth Medical, Inc.
• Cary H Mielke, M.D.
• Kelli Bagley Miers, OT
• Michael W. Miguez, MD
• Mihir V Patel MD LLC
• Robert Miketinas
• Akmal A Mikhail I, MD
• Miklos Szentirmai MD and Willis-Knighton Medical Center
• Brady Milanes
• Miles for Smiles, LLC

• Case Manager/Care Coordinator in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.