Individual provider Active NPI

Shonte' Patrice Daniels

  • Family Nurse Practitioner
  • Vidalia, LA
National Provider Identifier
1821552068
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F08180268 Issued in LA
Practice address
107 Front St Ste 2134
Vidalia, LA 71373-2834
Phone
(318) 336-2212
Fax
(318) 336-6067
NPI assigned
Jan 22, 2019
Last updated
Jan 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F08180268 LA Primary

Addresses

Primary practice location

107 Front St Ste 2134
Vidalia, LA 71373-2834

Mailing address

354 Deacon Wailes Rd
Ferriday, LA 71334-4300
Phone (713) 247-9574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190410000791 LA Practitioner - Nurse Practitioner 8628319191 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F08180268LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Oct 5, 2024 Accepting new patients
Vpa PC CurrentSince Oct 5, 2024 Accepting new patients

Locations

201 Victory Blvd
Ste 200
Monroe, LA 71203
Phone (877) 917-7010

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1821552068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 DEACON WAILES RD",
            "city": "FERRIDAY",
            "state": "LA",
            "postal_code": "713344300",
            "telephone_number": "713-247-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 FRONT ST STE 2134",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713732834",
            "telephone_number": "318-336-2212",
            "fax_number": "318-336-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "SHONTE'",
        "middle_name": "PATRICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "F08180268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, LA

Sources for this page

Verify at the official NPI Registry.