Active NPI
Brandon Hancock
- Counselor
- Shreveport, LA
National Provider Identifier
1649632209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 4650 Lakeshore Dr Apt 119
Shreveport, LA 71109-2950 - Phone
- (318) 834-5438
- NPI assigned
- Mar 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
4650 Lakeshore Dr Apt 119
Shreveport, LA 71109-2950
Mailing address
4650 Lakeshore Dr
Apt 119
Shreveport, LA 71109-2925
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009026727 | Medicaid | LA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458691200000",
"number": "1649632209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4650 LAKESHORE DR",
"address_2": "APT 119",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711092925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 LAKESHORE DR APT 119",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711092950",
"telephone_number": "318-834-5438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANCOCK",
"first_name": "BRANDON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-23",
"last_updated": "2016-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009026727",
"state": "LA"
}
],
"endpoints": [],
"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 Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.