SPECIALISTS HOSPITAL SHREVEPORT, LLC (NPI# 1104057694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104057694 |
| Entity Type | Organization |
| Organization Name | SPECIALISTS HOSPITAL SHREVEPORT, LLC |
| Practice Address |
1500 Line Avenue Suite 206 Shreveport LA 71101-4639 |
| Practice Telephone | 3182133800 |
| Practice Fax Number | 3182133801 |
| Mailing Telephone | 3182133800 |
| Mailing Fax Number | 3182133801 |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2011-05-06 |
| Authorized Official Name | MRS. KANDI G. MOORE (CEO) |
| Authorized Official Telephone | 3186326083 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers | ||
| Y | 282N00000X | General Acute Care Hospital | 626 | LA | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1702439 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912118134 | Specialists Hospital Shreveport, LLC | Special Hospital | 1500 Line Ave, Suite 206, Shreveport, LA 71101-4622 | 2007-05-28 |
| Street Address |
1500 LINE AVENUE SUITE 206 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295739001 | William L Overdyke | Orthopaedic Surgery | 1500 Line Avenue, Suite 100, Shreveport, LA 71101 | 2005-06-09 |
| 1790196657 | Specialists Hospital Shreveport | Pharmacy | 1500 Line Avenue, Suite 206, Shreveport, LA 71101 | 2014-05-14 |
| 1417189465 | Clay Eric Morgan | Physician Assistant | 1500 Line Avenue, Ste 100, Shreveport, LA 71101-4639 | 2009-08-10 |
| 1659503613 | Trey M Harold | Physician Assistant | 1500 Line Avenue, Suite 100, Shreveport, LA 71101-4639 | 2009-08-10 |
| 1598891491 | Stephen Michael Brandao Jr. | Nurse Practitioner | 1500 Line Avenue, Ste 200, Shreveport, LA 71101 | 2007-02-26 |
| 1992831895 | Joseph Michael Angelo | Physician Assistant | 1500 Line Avenue, Ste 100, Shreveport, LA 71101 | 2007-02-26 |
| 1891821583 | Chris D Howard | Nurse Practitioner | 1500 Line Avenue, Ste 200, Shreveport, LA 71101 | 2007-02-26 |
| 1255470118 | John David Googe | Orthopaedic Surgery | 1500 Line Avenue, Ste 100, Shreveport, LA 71101 | 2007-02-06 |
| 1346393816 | Michele Allison | Occupational Therapist | 1500 Line Avenue, Ste 100, Shreveport, LA 71101 | 2007-01-19 |
| 1073585477 | Philip Andrew Utter | Neurological Surgery | 1500 Line Avenue, Ste 200, Shreveport, LA 71101 | 2006-02-02 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902310899 | Islam LLC | General Acute Care Hospital | 9815 Paragon Ln, Shreveport, LA 71115 | 2017-11-30 |
| 1396073409 | Nelson & Nelson Apmc | General Acute Care Hospital | 9512 Balsa Dr, Shreveport, LA 71115-3127 | 2009-12-01 |
| 1912909912 | Brfhh Shreveport LLC | General Acute Care Hospital | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2005-08-10 |
| 1417950106 | Christus Health Northern Louisiana | General Acute Care Hospital | 1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105-6800 | 2005-05-27 |
| 1366064016 | The Carpenter Center for Palliative Medicine of Shreveport, LLC | General Acute Care Hospital | 8950 E Kings Hwy, Shreveport, LA 71115-2704 | 2020-05-15 |
| 1427536325 | University Health Shreveport LLC | General Acute Care Hospital | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2018-08-02 |
| 1386034387 | Obvamc | General Acute Care Hospital | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2015-01-28 |
| 1871927921 | Brfhh Shreveport, LLC | General Acute Care Hospital | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2013-08-26 |
| 1346585312 | Overton Brooks Va Medical Center | General Acute Care Hospital | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2012-12-03 |
| 1295974574 | Overton Brooks Vamc | General Acute Care Hospital | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2009-02-11 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
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| 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.