NPIMap

Organization Active NPI

Commcare Louisiana

  • Durable Medical Equipment & Medical Supplies
  • Pineville, LA
National Provider Identifier
1275690125
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
30440-011-0-2010 Issued in LA
Legal business name
COMMCARE LOUISIANA
Practice address
5201A Shreveport Highway
Pineville, LA 71360
Phone
(318) 640-2030
Fax
(318) 640-4927
NPI assigned
Jan 2, 2007
Last updated
Apr 11, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMCARE LOUISIANAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Authorized official

Name
Mr. John A. Stassi II
Title
Secretary and Director
Phone
(504) 324-8950

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 2730984-001 LA
Durable Medical Equipment & Medical Supplies 332B00000X 30440-011-0-2010 LA Primary

Addresses

Primary practice location

5201A Shreveport Highway
Pineville, LA 71360

Mailing address

4020 Greewood Road
Shreveport, LA 71109-0000
Phone (318) 631-1466

Other identifiers 2

IdentifierTypeStateIssuer
1677531MedicaidLA
1473715MedicaidLA

Other names 1

  • d/b/a Home Infusion and DME Services Former legal business name

National Provider Directory

National Provider Directory
Part of
Commcare Louisiana

Member organizations 24

Organizations listed as members of this organization in the National Provider Directory.

View all 24

Locations

601 Poydras St
Ste 2755
New Orleans, LA 70130

5201A Shreveport Hwy
Pineville, LA 71360
Phone (318) 640-2030

4020 Greenwood Rd
Shreveport, LA 71109
Phone (318) 631-1466

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302480000000",
    "number": "1275690125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 GREEWOOD ROAD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711090000",
            "telephone_number": "318-631-1466",
            "fax_number": "318-631-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201A SHREVEPORT HIGHWAY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "71360",
            "telephone_number": "318-640-2030",
            "fax_number": "318-640-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMCARE LOUISIANA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMCARE LOUISIANA",
        "enumeration_date": "2007-01-02",
        "last_updated": "2011-04-11",
        "status": "A",
        "authorized_official_last_name": "STASSI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SECRETARY AND DIRECTOR",
        "authorized_official_telephone_number": "504-324-8950",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": "2730984-001",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": "30440-011-0-2010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1677531",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1473715",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "d/b/a Home Infusion and DME Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pineville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; 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.