LSU HEALTH SCIENCES CENTER SHREVEPORT FACULTY GROUP PRACTICE (NPI# 1013374222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013374222 |
Entity Type | Organization |
Organization Name | LSU HEALTH SCIENCES CENTER SHREVEPORT FACULTY GROUP PRACTICE |
Practice Address |
1541 Kings Hwy Shreveport LA 71103-4228 |
Mailing Address |
1512 W Kirby Pl Shreveport LA 71103-3822 |
Practice Telephone | 3186260000 |
Mailing Telephone | 3186260284 |
Enumeration Date | 2016-01-19 |
Last Update Date | 2019-11-14 |
Authorized Official Name | VERNON MOORE (CFO) |
Authorized Official Telephone | 3186260990 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
N | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians | ||
N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
Street Address |
1541 KINGS HWY |
City | SHREVEPORT |
State | LA |
Zip Code | 71103-4228 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912909912 | Brfhh Shreveport LLC | General Acute Care Hospital | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2005-08-10 |
1851991947 | Gina Marie Kristiansen | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-28 |
1376142893 | Candice Crow | Internal Medicine | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-26 |
1518574441 | Jadebrey Vyshette Kennon | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-24 |
1629683230 | Amanda Renae Simmons | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-10 |
1255945382 | Frank James List | Pharmacy Technician | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-05 |
1700496312 | Caroline Leigh Harris | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-07 |
1740899400 | Brittany Allyson Bozzell | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-07-29 |
1386253169 | Kristyn Turner | Pharmacist | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-07-28 |
1508481722 | Alexandra Blair Lemaire | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-06-12 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
Find all providers in zip 71103 |
Taxonomy Code | 207R00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790315026 | Cody Tingle Md LLC | Internal Medicine | 535 Pierremont Rd, Shreveport, LA 71106-2207 | 2020-01-26 |
1538654306 | Masri Group LLC | Internal Medicine | 3801 Creswell Ave Unit 19, Shreveport, LA 71106-1257 | 2018-06-25 |
1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
1760923064 | Martin Marak | Internal Medicine | 847 Prospect St, Shreveport, LA 71104-3025 | 2017-03-20 |
1265883482 | Vari LLC | Internal Medicine | 506 Rock Hollow Dr, Shreveport, LA 71115-2502 | 2016-06-29 |
1598140121 | Mihir V Patel Md LLC | Internal Medicine | 9930 Loveland Ct, Shreveport, LA 71106-7795 | 2015-07-24 |
1619357209 | Chad Michael Gibson | Internal Medicine | 8001 Youree Dr Ste 4007, Shreveport, LA 71115-2302 | 2015-06-09 |
1265829394 | Amanda Lynn Callegan-poche' | Internal Medicine | 1023 Provenance Pl Ste 130, Shreveport, LA 71106-7796 | 2015-04-15 |
1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
1477807980 | Ronald Baylis George | Internal Medicine | 1821 Willow Point Drive, Shreveport, LA 71119 | 2012-11-06 |
Find all providers in SHREVEPORT |
City | SHREVEPORT |
Zip Code | 71103 |
Please comment or provide details below to improve the information on LSU HEALTH SCIENCES CENTER SHREVEPORT FACULTY GROUP PRACTICE.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.