Active NPI
Tanquenika Markray, APRN
- Pediatric Nurse Practitioner
- Shreveport, LA
National Provider Identifier
1376092510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- AP08926
- Practice address
- 351 Hearne Ave
Shreveport, LA 71103-2019 - Phone
- (318) 603-7218
- Fax
- (318) 364-1718
- NPI assigned
- Sep 29, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | AP08926 | LA | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | AP132093 | TX |
Addresses
Primary practice location
351 Hearne Ave
Shreveport, LA 71103-2019
Mailing address
3041 Dr Martin Luther King Dr
Shreveport, LA 71107-4705
Phone (318) 227-3350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2458507 | Medicaid | LA |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP08926 | LA | MD | Pediatric Nurse Practitioner |
| AP132093 | TX | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Raines Community Health Center, Inc. | Past | Accepting new patients |
Interoperability endpoints
- tanquenika.markraycpnp.p1@direct.davidraineschc.nextgenshare.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Shreveport, LA
- NPI 1760042394
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525219200000",
"number": "1376092510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3041 DR MARTIN LUTHER KING DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711074705",
"telephone_number": "318-227-3350",
"fax_number": "318-222-2979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "351 HEARNE AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711032019",
"telephone_number": "318-603-7218",
"fax_number": "318-364-1718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKRAY",
"first_name": "TANQUENIKA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-29",
"last_updated": "2018-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "LA",
"license": "AP08926",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TX",
"license": "AP132093",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2458507",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.