Individual provider Active NPI

Stephanie Lynn Holifield, LPN

  • Licensed Practical Nurse
  • Baton Rouge, LA
National Provider Identifier
1396490686
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
20150369 Issued in LA
Practice address
11445 Reiger Rd
Baton Rouge, LA 70809-4556
Phone
(225) 932-9867
NPI assigned
Feb 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 20150369 LA Primary

Addresses

Primary practice location

11445 Reiger Rd
Baton Rouge, LA 70809-4556

Mailing address

11445 Reiger Rd
Baton Rouge, LA 70809-4556
Phone (225) 932-9867

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

State licenses

LicenseStateTypeSpecialty
20150369LAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Treatment Center, LLC CurrentSince Feb 24, 2022 Accepting new patients

Locations

11445 Reiger Rd
Baton Rouge, LA 70809
Phone (225) 877-3499

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": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1396490686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11445 REIGER RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708094556",
            "telephone_number": "225-932-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11445 REIGER RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708094556",
            "telephone_number": "225-932-9867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLIFIELD",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "LA",
            "license": "20150369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.