BRENTWOOD ACQUISITION SHREVEPORT, INC


Address: 1002 Highland Ave, Suite 200, Shreveport, LA 71101-4143
Phone: 3182226226

BRENTWOOD ACQUISITION SHREVEPORT, INC (NPI# 1063644383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063644383
Entity Type Organization
Organization Name BRENTWOOD ACQUISITION SHREVEPORT, INC
Other Organization Name BRENTWOOD OUTPATIENT CLINIC
Practice Address 1002 Highland Ave
Suite 200
Shreveport
LA 71101-4143
Practice Telephone 3182226226
Practice Fax Number 3182226227
Mailing Telephone 3182226226
Mailing Fax Number 3182226227
Enumeration Date 2009-08-20
Last Update Date 2009-08-20
Authorized Official Name MRS. JODI LYNN BURNS (OFFICE MANAGER)
Authorized Official Telephone 3182226260
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM2500X Clinic/Center
Specialization: Medical Specialty
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Brentwood Outpatient Clinic Doing Business As Name - Organization

Office Location

Street Address 1002 HIGHLAND AVE
SUITE 200
City SHREVEPORT
State LA
Zip Code 71101-4143

Providers in the same location

NPI Name Taxonomy Address Enumeration
1356319453 Larrie Ann Williamson Specialist 1002 Highland Ave, Suite 201, Shreveport, LA 71101-4143 2006-03-14
1841792249 James G Jones IIi Nurse Practitioner 1002 Highland Ave, Shreveport, LA 71101-4143 2018-03-02
1487009833 Lauren A Lusk Md LLC Psychiatry & Neurology 1002 Highland Ave, Suite 300, Shreveport, LA 71101-4143 2016-05-03
1609202332 John H Wagner,iii,md,llc Psychiatry & Neurology 1002 Highland Ave, Ste 300, Shreveport, LA 71101-4143 2013-09-26
1205135308 Laura C Mcferrin, Bcsw, Lcsw Social Worker 1002 Highland Ave, Suite 200, Shreveport, LA 71101-4143 2011-03-15
1730487844 M Patrick Davenport Appc Psychologist 1002 Highland Ave, 3rd Floor, Shreveport, LA 71101-4143 2011-03-14
1700188810 Lee Stevens Md A Professional Medical Corporation Psychiatry & Neurology 1002 Highland Ave, Ste 300, Shreveport, LA 71101-4143 2010-11-22
1386881589 Wendy Genora Bowlin Counselor 1002 Highland Ave, Ste. 101, Shreveport, LA 71101-4143 2009-01-10
1942498506 A. Paul Willcox Social Worker 1002 Highland Ave, Suite 200, Shreveport, LA 71101-4143 2007-10-09
1871793935 Mona Muriel Qualls Counselor 1002 Highland Ave, Suite 300, Shreveport, LA 71101-4143 2007-07-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255988630 Renee Jewitt Case Manager/Care Coordinator 1513 Line Avenue, Suite 225, Shreveport, LA 71101 2019-08-21
1942770094 Bessie Larry Case Manager/Care Coordinator 1513 Line Av, 222, Shreveport, LA 71101 2018-12-03
1750875944 Jarvis Decarleonne Larry Community Health Worker 1513 Line Ave # 222, Shreveport, LA 71101 2018-06-20
1871083485 Kimberly B. Mcclelland, Lcsw Counselor 820 Jordan St. Ste 510w, Shreveport, LA 71101 2018-05-18
1982106456 Hudson Amc LLC Internal Medicine 1800 Irving Place, Shreveport, LA 71101 2018-03-01
1528572955 Spencer Ron Floyd Counselor 1717 Marshall Street, Shreveport, LA 71101 2017-11-21
1578088076 Brittany Morris Case Manager/Care Coordinator 1835 Spring Street Annex Building, Shreveport, LA 71101 2017-08-07
1275058794 Diane Williams Case Manager/Care Coordinator 217 Jones St Apt 510, Shreveport, LA 71101 2017-08-04
1386195972 Jakeya Woodbury Counselor 453 Stoner Ave, Shreveport, LA 71101 2016-10-18
1922459643 Arlene Huling Counselor 449 Egan Street, Shreveport, LA 71101 2016-06-23
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Taxonomy Information

Taxonomy Code 261QM2500X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Medical Specialty

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1205022647 Jct Medical Consulting Clinic/Center 460 Ashley Ridge Blvd Ste 500, Shreveport, LA 71106-7228 2007-09-19
1235625252 Discrete Enterprises Clinic/Center 5100 Pine Hill Rd, Shreveport, LA 71107 2018-07-02
1225211089 Marco A. Ramos, M.d. Apc Clinic/Center 2800 Hearne Ave, Shreveport, LA 71103-3934 2007-12-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1679193593 L & F Ross Transportation, LLC Clinic/Center 2645 Taffy Dr, Marrero, LA 70072-5745 2020-04-21
1649709452 Guste Plastic and Reconstructive Surgery, LLC Clinic/Center 3900 Veterans Blvd., Suite 200, Metairie, LA 70002 2017-06-06
1508227604 Acadiana Allergy, Asthma and Immunology Center, LLC Clinic/Center 300 Rue Beauregard Ste F, Lafayette, LA 70508 2016-03-16
1215398631 Stonewall Eye Care Clinic/Center 2434 Highway 171, Stonewall, LA 71078-9420 2016-03-11
1306273511 Va Culotta Jr Md LLC Clinic/Center 4420 Conlin St., Ste 300, Metairie, LA 70006 2013-10-02
1306109350 Active Spine Care LLC Clinic/Center 8108 Picardy Ave Ste E, Baton Rouge, LA 70809-3514 2012-06-22
1003183047 Clear Imaging LLC Clinic/Center 1241a 7th St, Slidell, LA 70458-2041 2011-11-18
1295064004 Cynthia A. Williams, A.p.m.c. Clinic/Center 3555 Loyola Dr, Kenner, LA 70065-7706 2009-12-08
1205075256 Peter Hertzak M.d. Pmc Clinic/Center 985 Robert Blvd Ste 102, Slidell, LA 70458-2063 2009-02-16
1215191903 Myriam D Hutchinson Md Clinic/Center 104 N. Hospital Dr., Abbeville, LA 70510-4039 2008-07-11
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Competitor

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City SHREVEPORT
Zip Code 71101

Improve Information

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Dataset Information

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.

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