Active NPI
Kara Vantaggi, PHARMD
- Pharmacist
- Moss Bluff, LA
National Provider Identifier
1366994493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.021805
- Practice address
- 120 N Highway 171
Moss Bluff, LA 70611-5343 - Phone
- (337) 855-4848
- NPI assigned
- Oct 24, 2016
- Last updated
- Oct 24, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.021805 | LA | Primary |
Addresses
Primary practice location
120 N Highway 171
Moss Bluff, LA 70611-5343
Mailing address
1330 W McNeese St Apt 10314
Lake Charles, LA 70605-4495
Phone (440) 623-0794
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.021805 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477267200000",
"number": "1366994493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 W MCNEESE ST APT 10314",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706054495",
"telephone_number": "440-623-0794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 N HIGHWAY 171",
"city": "MOSS BLUFF",
"state": "LA",
"postal_code": "706115343",
"telephone_number": "337-855-4848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANTAGGI",
"first_name": "KARA",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-24",
"last_updated": "2016-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.021805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moss Bluff, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.