Active NPI
Tricia Quinn Tebboth, M.D.
- Family Medicine Physician
- Shreveport, LA
National Provider Identifier
1841597176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 024380
- Practice address
- 653 W 70TH St
Shreveport, LA 71106-2949 - Phone
- (318) 636-8389
- Fax
- (318) 636-8389
- NPI assigned
- Feb 23, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 024380 | LA | Primary |
Addresses
Primary practice location
653 W 70TH St
Shreveport, LA 71106-2949
Mailing address
4037 Barbe Wood Dr
Lake Charles, LA 70605-2352
Phone (337) 478-8744
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024380 | LA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osh-in Physicians Group, PC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Indianapolis, IN
- NPI 1073995338
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695254400000",
"number": "1841597176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4037 BARBE WOOD DR",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706052352",
"telephone_number": "337-478-8744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "653 W 70TH ST",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711062949",
"telephone_number": "318-636-8389",
"fax_number": "318-636-8389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEBBOTH",
"first_name": "TRICIA",
"middle_name": "QUINN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-23",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "LA",
"license": "024380",
"primary": true
}
],
"identifiers": [],
"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 Sep 21, 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.