Individual provider Active NPI

Tanquenika Markray, APRN

  • Pediatric Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1376092510
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP08926 Issued in LA
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

Updated by the provider on May 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2458507MedicaidLA

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

LicenseStateTypeSpecialty
AP08926LAMDPediatric Nurse Practitioner
AP132093TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
David Raines Community Health Center, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.