NPIMap

Organization Active NPI

Impact Transit Service

  • Non-emergency Medical Transport (VAN)
  • Shreveport, LA
National Provider Identifier
1508697723
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
IMPACT TRANSIT SERVICE
Practice address
4727 Broadway Ave
Shreveport, LA 71109-6908
Phone
(318) 349-9394
Fax
(318) 470-4636
NPI assigned
Aug 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Authorized official

Name
Rasby G Mason IINPI 1649001868
Title
Owner
Phone
(318) 349-9394

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X
Clinic/Center 261Q00000X
Adult Day Care Clinic/Center 261QA0600X
VA Clinic/Center 261QV0200X
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

4727 Broadway Ave
Shreveport, LA 71109-6908

Mailing address

1007 Gould Drive
Building 1 Suite 1
Bosier City, LA 71111
Phone (318) 349-9394

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL IMPACTTRANSITSRVS@GMAIL.COM

National Provider Directory

National Provider Directory

Locations

4727 Broadway Ave
Shreveport, LA 71109
Phone (318) 349-9394

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": "1723161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1508697723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 GOULD DRIVE",
            "address_2": "BUILDING 1 SUITE 1",
            "city": "BOSIER CITY",
            "state": "LA",
            "postal_code": "71111",
            "telephone_number": "318-349-9394",
            "fax_number": "318-626-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4727 BROADWAY AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711096908",
            "telephone_number": "318-349-9394",
            "fax_number": "318-470-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT TRANSIT SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "RASBY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-349-9394",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "IMPACTTRANSITSRVS@GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "EMAIL ADDRESS",
            "address_1": "4727 Broadway Ave",
            "city": "Shreveport",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711096908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Sep 9, 2024; 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.