Active NPI
Charette Dellagatta, RN, CCRP
- Diabetes Educator Registered Nurse
- Shreveport, LA
National Provider Identifier
1871108357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- RN148778
- Practice address
- 1449 E Bert Koun Loop Ste 102
Shreveport, LA 71105-5663 - Phone
- (318) 681-5353
- Fax
- (318) 681-6305
- NPI assigned
- Sep 11, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiac Rehabilitation Registered Nurse | 163WC3500X | RN148778 | LA | |
| Diabetes Educator Registered Nurse | 163WD0400X | RN148778 | LA | Primary |
Addresses
Primary practice location
1449 E Bert Koun Loop Ste 102
Shreveport, LA 71105-5663
Mailing address
6021 Dillingham Ave
Shreveport, LA 71106-2109
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN148778 | LA | MD | Cardiac Rehabilitation Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599782400000",
"number": "1871108357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6021 DILLINGHAM AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711062109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1449 E BERT KOUN LOOP STE 102",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711055663",
"telephone_number": "318-681-5353",
"fax_number": "318-681-6305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELLAGATTA",
"first_name": "CHARETTE",
"credential": "RN, CCRP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-11",
"last_updated": "2020-09-11",
"certification_date": "2020-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "163WC3500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Cardiac Rehabilitation",
"state": "LA",
"license": "RN148778",
"primary": false
},
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "LA",
"license": "RN148778",
"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 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.