Active NPI
Mary E Severance, LPN2
- Licensed Practical Nurse
- Pineville, LA
National Provider Identifier
1306023395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 800608
- Practice address
- 242 Shamrock St
Red River Addictions Complex
Pineville, LA 71306 - Phone
- (318) 484-6614
- Fax
- (318) 487-5703
- NPI assigned
- Jan 22, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 800608 | LA | Primary |
Addresses
Primary practice location
242 Shamrock St
Red River Addictions Complex
Pineville, LA 71306
Mailing address
PO Box 7118
Alexandria, LA 71306-0118
Phone (318) 484-6614
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 800608 | LA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200960000000",
"number": "1306023395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7118",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713060118",
"telephone_number": "318-484-6614",
"fax_number": "318-487-5703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 SHAMROCK ST",
"address_2": "RED RIVER ADDICTIONS COMPLEX",
"city": "PINEVILLE",
"state": "LA",
"postal_code": "71306",
"telephone_number": "318-484-6614",
"fax_number": "318-487-5703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVERANCE",
"first_name": "MARY",
"middle_name": "E",
"credential": "LPN2",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-22",
"last_updated": "2008-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "LA",
"license": "800608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jan 22, 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.