Individual provider Active NPI

Divante Gee'Coldbe Irby

  • Speech-Language Assistant
  • Clinton, LA
National Provider Identifier
1336875368
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
Practice address
12732 Silliman St
Clinton, LA 70722-3402
Phone
(225) 683-5922
NPI assigned
Aug 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X Primary

Addresses

Primary practice location

12732 Silliman St
Clinton, LA 70722-3402

Mailing address

12732 Silliman St
Clinton, LA 70722-3402
Phone (225) 683-5922

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": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1336875368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12732 SILLIMAN ST",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707223402",
            "telephone_number": "225-683-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12732 SILLIMAN ST",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707223402",
            "telephone_number": "225-683-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRBY",
        "first_name": "DIVANTE",
        "middle_name": "GEE'COLDBE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.