Individual provider Active NPI

Valentino Isaac Parris, FNP

  • Family Nurse Practitioner
  • Fort Polk, LA
National Provider Identifier
1972561009
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
62291 Issued in HI
Practice address
1585 3Rd Street
Bayne-Jones Hospital,
Fort Polk, LA 71459-5110
Phone
(337) 531-3349
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 51419 HI
Family Nurse Practitioner 363LF0000X 62291 HI Primary

Addresses

Primary practice location

1585 3Rd Street
Bayne-Jones Hospital,
Fort Polk, LA 71459-5110

Mailing address

206 3Rd St
New Llano, LA 71461-9722
Phone (760) 267-4652

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

State licenses

LicenseStateTypeSpecialty
51419HIMDRegistered Nurse
62291HIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1972561009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 3RD ST",
            "city": "NEW LLANO",
            "state": "LA",
            "postal_code": "714619722",
            "telephone_number": "760-267-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 3RD STREET",
            "address_2": "BAYNE-JONES HOSPITAL,",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714595110",
            "telephone_number": "337-531-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRIS",
        "first_name": "VALENTINO",
        "middle_name": "ISAAC",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "51419",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "62291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Polk, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.