Active NPI
Greta Anita McCormick, MSN, APRN, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Shreveport, LA
National Provider Identifier
1215102462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 227483
- Practice address
- 151 Freestate Blvd Ste a
Shreveport, LA 71107-6549 - Phone
- (318) 226-5990
- NPI assigned
- Apr 29, 2008
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 227483 | LA | Primary |
Addresses
Primary practice location
151 Freestate Blvd Ste a
Shreveport, LA 71107-6549
Mailing address
1310 N Hearne Ave
Shreveport, LA 71107-6516
Phone (318) 676-5111
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)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227483 | LA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1215102462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 N HEARNE AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711076516",
"telephone_number": "318-676-5111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 FREESTATE BLVD STE A",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711076549",
"telephone_number": "318-226-5990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "GRETA",
"middle_name": "ANITA",
"name_prefix": "Ms.",
"credential": "MSN, APRN, PMHNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-29",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "LA",
"license": "227483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.