DR. BRADLY KENDALL LARSON (NPI# 1053729152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053729152 |
| Entity Type | Individual |
| Full Name | DR. BRADLY KENDALL LARSON |
| Credential | O.D. |
| Practice Address |
8889 Jewella Ave Ste C Shreveport LA 71118-2138 |
| Practice Telephone | 3186865227 |
| Practice Fax Number | 3816865283 |
| Mailing Telephone | 3186865227 |
| Mailing Fax Number | 3816865283 |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2014-08-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1775-709T | LA | Eye and Vision Services Providers |
| Street Address |
8889 JEWELLA AVE STE C |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-2138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620784 | Wk Center for Pediatric Gastroenterology | Pediatrics | Wk Center for Pediatric Gastroenterology, 2530 Bert Kouns Industrial Loop, Ste 113, Shreveport, LA 71118 | 2019-10-11 |
| 1306302443 | Diamond Marie Willis | Case Manager/Care Coordinator | 9403 Mansfield Rd., Shreveport, LA 71118 | 2019-02-13 |
| 1194224469 | Latosa Hall | Case Manager/Care Coordinator | 9007 Letha Loop, Shreveport, LA 71118 | 2018-02-01 |
| 1902321623 | Bersheika Lashay Player | Counselor | 9403 Mansfield Road, Shreveport, LA 71118 | 2017-08-03 |
| 1518487149 | Clarke Jackson | Case Manager/Care Coordinator | 9730 Baird Rd Apt 2310, Shreveport, LA 71118 | 2017-06-24 |
| 1770010449 | Darrie'l Smith | Counselor | 2715 Mackey, Shreveport, LA 71118 | 2017-05-12 |
| 1760917041 | Delilah Wells | Case Manager/Care Coordinator | 9005 Walker Rd Apt 722, Shreveport, LA 71118 | 2017-04-25 |
| 1790229664 | We Care Transporttion Services LLC | Secured Medical Transport (VAN) | 2529 Summer Grove Dr, Shreveport, LA 71118 | 2016-12-13 |
| 1063955128 | Commanisha Smith | Social Worker | 2715 Mackey Place, Shreveport, LA 71118 | 2016-11-22 |
| 1023560802 | Yasmin Newman | Counselor | 9812 West Trails End, Shreveport, LA 71118 | 2016-10-27 |
| Find all providers in zip 71118 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225512296 | Daniel & Max LLC | Optometrist | 1655 E Bert Kouns Industrial Loop Ste 100, Shreveport, LA 71105-5726 | 2018-09-17 |
| 1619353786 | Jessica Lantz | Optometrist | 2530 W Bert Kouns Industrial Loop, Shreveport, LA 71118-7111 | 2015-07-30 |
| 1720464878 | Travis Jones | Optometrist | 2530 Bert Kouns Industrial Loop Ste 116, Shreveport, LA 71118-3153 | 2015-07-30 |
| 1679876023 | George Michael Bakowski | Optometrist | 1133 Saint Vincent Ave, Ste 120, Box 216, Shreveport, LA 71104-4153 | 2010-12-07 |
| 1871729277 | Amy Elizabeth Coburn | Optometrist | Highland Clinic, Apmc, 1400 E. Bert Kouns, Suite #103, Shreveport, LA 71105 | 2009-06-01 |
| 1336273150 | Charles Dennis Shanks | Optometrist | 7110 Youree Drive, Shreveport, LA 71105 | 2007-03-15 |
| 1730222472 | George M Bakowski Od PC | Optometrist | 1133 St. Vincent Ave # 216 Suite 120, Mall St. Vincent, Shreveport, LA 71104-4147 | 2007-02-14 |
| 1609918945 | Rudolph W. Troup Jr. | Optometrist | 8889 Jewella Ave, Suite D, Shreveport, LA 71118-2138 | 2007-02-13 |
| 1891889267 | Sam Ray Silverblatt | Optometrist | 1803 E 70th St, Shreveport, LA 71105-5301 | 2006-10-03 |
| 1164516340 | Philip A. Lahaye | Optometrist | 7020 Youree Dr Ste A, Shreveport, LA 71105-5109 | 2006-10-03 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
Please comment or provide details below to improve the information on DR. BRADLY KENDALL LARSON.
| 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.