Individual provider Active NPI

Tommie Nelson

  • Case Manager/Care Coordinator
  • Ruston, LA
National Provider Identifier
1376903542
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
107 W Alabama Ave
Ruston, LA 71270-4403
Phone
(318) 224-7170
Fax
(318) 224-7063
NPI assigned
Mar 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

107 W Alabama Ave
Ruston, LA 71270-4403

Mailing address

107 W Alabama Ave
Ruston, LA 71270-4403
Phone (318) 224-7170

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": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1376903542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W ALABAMA AVE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712704403",
            "telephone_number": "318-224-7170",
            "fax_number": "318-224-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W ALABAMA AVE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712704403",
            "telephone_number": "318-224-7170",
            "fax_number": "318-224-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TOMMIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-02",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.