NPIMap

Individual provider Active NPI

Tanquila Quene Lasalle

  • Prosthetics Case Management
  • Lake Charles, LA
National Provider Identifier
1770220329
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
L142600526 Issued in LA
Practice address
2601 Hodges St
Lake Charles, LA 70601-7311
Phone
(337) 439-5628
NPI assigned
May 16, 2022
Last updated
May 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X L142600526 LA Primary

Addresses

Primary practice location

2601 Hodges St
Lake Charles, LA 70601-7311

Mailing address

2601 Hodges St
Lake Charles, LA 70601-7311
Phone (337) 439-5628

Other identifiers 1

IdentifierTypeStateIssuer
850700187MedicaidLA

Electronic endpoints 3

TypeEndpointUseAffiliation
Other URL Blackberry Other
Other URL Blackberry Other
Other URL Blackberry Other

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

State licenses

LicenseStateTypeSpecialty
L142600526LAMDProsthetics Case Management

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1770220329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 HODGES ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017311",
            "telephone_number": "337-439-5628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 HODGES ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017311",
            "telephone_number": "337-439-5628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASALLE",
        "first_name": "TANQUILA",
        "middle_name": "QUENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "LA",
            "license": "L142600526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "850700187",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Blackberry",
            "affiliation": "N",
            "endpointDescription": "Blackberry",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Client files",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Blackberry",
            "address_1": "2601 Hodges St",
            "city": "Lake Charles",
            "state": "LA",
            "country_code": "US",
            "postal_code": "706017311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Blackberry",
            "affiliation": "N",
            "endpointDescription": "Blackberry",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Blackberry",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "2601 Hodges St",
            "city": "Lake Charles",
            "state": "LA",
            "country_code": "US",
            "postal_code": "706017311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Blackberry",
            "affiliation": "N",
            "endpointDescription": "Blackberry",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Blackberry",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2601 Hodges St",
            "city": "Lake Charles",
            "state": "LA",
            "country_code": "US",
            "postal_code": "706017311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.