Phyllis Caudill

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

906229 Issued in MS

Practice address

1860 Fairfield Ave
Shreveport, LA 71101-4431

Phone

(318) 642-9450

NPI assigned

Dec 4, 2023

Last updated

Dec 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1568239283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 FAIRFIELD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014431",
            "telephone_number": "318-642-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 FAIRFIELD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014431",
            "telephone_number": "318-642-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDILL",
        "first_name": "PHYLLIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "906229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine F Vanderloos
• Catherine F. Vanderloos, MD Facog AMC
• Angela Michelle Cathron
• David Cato
• Tiesha Cato
• Christopher Davis Causey, MD
• Renee Causey, ACNP
• David A Cavanaugh, MD
• Tiffany Tebree Cavitt
• Veda Cawthorn

• Primary Care Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Primary Care Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.