Active NPI
Tyronell Monique Davis, COSMETOLOGIST
- Prosthetist
- New Orleans, LA
National Provider Identifier
1982259644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- License
- 386069
- Practice address
- 4066 Gibson St
New Orleans, LA 70122-1622 - Phone
- (504) 266-6601
- NPI assigned
- Aug 8, 2019
- 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 |
|---|---|---|---|---|
| Prosthetist | 224P00000X | 386069 | LA | Primary |
Addresses
Primary practice location
4066 Gibson St
New Orleans, LA 70122-1622
Mailing address
4066 Gibson St
New Orleans, LA 70122-1622
Phone (504) 266-6601
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 386069 | LA | MD | Prosthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565222400000",
"number": "1982259644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4066 GIBSON ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701221622",
"telephone_number": "504-266-6601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4066 GIBSON ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701221622",
"telephone_number": "504-266-6601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TYRONELL",
"middle_name": "MONIQUE",
"credential": "COSMETOLOGIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-08",
"last_updated": "2019-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "LA",
"license": "386069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.