Individual provider Active NPI

Terry Square, RN

  • Registered Nurse
  • Clinton, LA
National Provider Identifier
1841848041
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN089514 Issued in LA
Practice address
11990 Jackson St
Clinton, LA 70722-3210
Phone
(225) 683-5292
Fax
(225) 683-1310
NPI assigned
Aug 30, 2019
Last updated
Aug 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN089514 LA Primary

Addresses

Primary practice location

11990 Jackson St
Clinton, LA 70722-3210

Mailing address

PO Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292

Other identifiers 1

IdentifierTypeStateIssuer
RN089514OtherLARN LICENSE

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN089514LAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1841848041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707220395",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11990 JACKSON ST",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707223210",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUARE",
        "first_name": "TERRY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN089514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN089514",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.