NPIMap

Organization Active NPI

West State MHT LLC

  • Family Medicine Physician
  • Leesville, LA
National Provider Identifier
1417379447
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11865R Issued in LA
Legal business name
WEST STATE MHT LLC
Practice address
379 Peavy Rd
Leesville, LA 71446-9514
Phone
(855) 860-2109
NPI assigned
Jan 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Authorized official

Name
Steven Smith
Title
Manager of Regulatory Compliance
Phone
(855) 860-2109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 11865R LA Primary

Addresses

Primary practice location

379 Peavy Rd
Leesville, LA 71446-9514

Mailing address

1515 Heritage Dr
Suite 110
McKinney, TX 75069-3379
Phone (855) 860-2109

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1417379447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 HERITAGE DR",
            "address_2": "SUITE 110",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750693379",
            "telephone_number": "855-860-2109",
            "fax_number": "855-814-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 PEAVY RD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714469514",
            "telephone_number": "855-860-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST STATE MHT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MANAGER OF REGULATORY COMPLIANCE",
        "authorized_official_telephone_number": "855-860-2109"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "11865R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.