Innis Addison

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

200 N Thomas Dr
Suite 100
Shreveport, LA 71107-6503

Phone

(318) 424-8345

NPI assigned

Mar 1, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Innis Addison Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1477093060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7607 FERN AVE STE 902",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055745",
            "telephone_number": "318-524-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N THOMAS DR",
            "address_2": "SUITE 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711076503",
            "telephone_number": "318-424-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDISON",
        "first_name": "INNIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-01",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "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": [
        {
            "first_name": "INNIS",
            "last_name": "ADDISON",
            "credential": "M. S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Yolanda Nanette Adams, LCSW
• Deborah K Adcock, M.D.
• Kristen Adcock
• William Adcock
• Derrick Lamar Addison Sr.
• Kasi M. Addison, DO
• Ashley Elaine Addy, NP
• Sodiq Tolani Adebeshin, MD
• Omosalewa Adegboyega
• Patrick A Adegboyega, M.D.

• Case Manager/Care Coordinator in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.