Active NPI
Sparky Joel Trahan, PSS
- Peer Specialist
- Houma, LA
National Provider Identifier
1326609462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 5599 Highway 311
Houma, LA 70360-2866 - Phone
- (985) 857-3615
- Fax
- (985) 876-8824
- NPI assigned
- Jun 27, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | LA | Primary |
Addresses
Primary practice location
5599 Highway 311
Houma, LA 70360-2866
Mailing address
124A Hollywood St
Thibodaux, LA 70301-4322
Phone (985) 857-3615
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 461634964 | Other | LA | PEER SUPPORT SPECIALLIST |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1326609462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124A HOLLYWOOD ST",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703014322",
"telephone_number": "985-857-3615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5599 HIGHWAY 311",
"city": "HOUMA",
"state": "LA",
"postal_code": "703602866",
"telephone_number": "985-857-3615",
"fax_number": "985-876-8824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAHAN",
"first_name": "SPARKY",
"middle_name": "JOEL",
"credential": "PSS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-27",
"last_updated": "2020-09-10",
"certification_date": "2020-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "LA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEER SUPPORT SPECIALLIST",
"identifier": "461634964",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houma, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.