NPIMap

Organization Active NPI

A Beam of Light LLC

  • Personal Care Attendant
  • Marrero, LA
National Provider Identifier
1235311291
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
9793 Issued in LA
Legal business name
A BEAM OF LIGHT LLC
Practice address
5201 Westbank Expressway
Suite 315
Marrero, LA 70072
Phone
(504) 328-1627
Fax
(504) 328-1467
NPI assigned
Dec 3, 2007
Last updated
Mar 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Authorized official

Name
Annette Revader
Title
Owner/Administrator
Phone
(504) 328-1627

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X 9793 LA Primary

Addresses

Primary practice location

5201 Westbank Expressway
Suite 315
Marrero, LA 70072

Mailing address

P O Box 925
Marrero, LA 70073
Phone (504) 328-1627

Other identifiers 1

IdentifierTypeStateIssuer
1170399MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
A Beam of Light LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1235311291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 925",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70073",
            "telephone_number": "504-328-1627",
            "fax_number": "504-328-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WESTBANK EXPRESSWAY",
            "address_2": "SUITE 315",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-328-1627",
            "fax_number": "504-328-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BEAM OF LIGHT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "REVADER",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "504-328-1627"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "LA",
            "license": "9793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1170399",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.