Active NPI
Tanganyika Peterson
- Home Health Aide
- Shreveport, LA
National Provider Identifier
1972246627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 9312 Cana Dr
Shreveport, LA 71118-2808 - Phone
- (318) 470-0308
- NPI assigned
- Apr 19, 2022
- Last updated
- Apr 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Primary |
Addresses
Primary practice location
9312 Cana Dr
Shreveport, LA 71118-2808
Mailing address
9312 Cana Dr
Shreveport, LA 71118-2808
Phone (318) 470-0308
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650326400000",
"number": "1972246627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9312 CANA DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711182808",
"telephone_number": "318-470-0308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9312 CANA DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711182808",
"telephone_number": "318-470-0308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "TANGANYIKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-19",
"last_updated": "2022-04-19",
"certification_date": "2022-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"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 Apr 19, 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.