WK PEDIATRIC HEALTHCARE ASSOCIATES (NPI# 1215216494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215216494 |
| Entity Type | Organization |
| Organization Name | WK PEDIATRIC HEALTHCARE ASSOCIATES |
| Practice Address |
1717 E Bert Kouns Industrial Loop Shreveport LA 71105-5561 |
| Practice Telephone | 3182122920 |
| Practice Fax Number | 3182122910 |
| Mailing Telephone | 3182122920 |
| Mailing Fax Number | 3182122910 |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2011-08-05 |
| Authorized Official Name | GREG J GAVIN (NETWORK ADMINISTRATOR) |
| Authorized Official Telephone | 3182424232 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Street Address |
1717 E BERT KOUNS INDUSTRIAL LOOP |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5561 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053399410 | Lynne F Holladay | Pediatrics | 1717 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5561 | 2006-01-05 |
| 1306906730 | The Asthma Allergy Clinic | Specialist | 1717 E Bert Kouns Industrial Loop, Suite B, Shreveport, LA 71105-5561 | 2006-12-08 |
| 1538147996 | Charlotte A Brown | Pediatrics | 1717 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5561 | 2006-01-05 |
| 1194703561 | Pediatric Associates of Shreveport, LLC | Pediatrics | 1717 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5561 | 2006-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619311438 | Amanda Vice Haynie | Pediatrics | 2225 Line Avenue, Mid City Pediatrics, Shreveport, LA 71104 | 2013-04-23 |
| 1487913976 | Greg M Oji | Pediatrics | 2508 Bert Kouns Industrial Loop Ste 320, Shreveport, LA 71118-3154 | 2012-05-03 |
| 1497011001 | Tamara Lynn Moore | Pediatrics | 1811 E Bert Kouns Industrial Loop Ste 140, Shreveport, LA 71105-5741 | 2012-04-09 |
| 1316228984 | Choice Pediatrics, LLC | Pediatrics | 6930 Fern Ave, Suite 150, Shreveport, LA 71105-4100 | 2011-09-08 |
| 1598077323 | Virginia Homza Carter | Pediatrics | 909 Olive St, Shreveport, LA 71104 | 2010-07-09 |
| 1891938239 | Nicolette Humphries | Pediatrics | 2518 Bert Kouns Ind. Loop, Shreveport, LA 71118-3112 | 2009-04-15 |
| 1407042435 | Hester Suh | Pediatrics | 2709 Mackey Ln, Shreveport, LA 71118-2556 | 2007-09-24 |
| 1639203367 | Suyah M Loud | Pediatrics | 4140 Hollywood Ave, Suite B-2, Shreveport, LA 71109-7818 | 2007-03-15 |
| 1891833869 | Holliway Medical Clinic LLC | Pediatrics | 3824 Hearne Ave, Shreveport, LA 71103 | 2007-02-02 |
| 1134295520 | D Gene Mack Jr Md and Willis-knighton Medical Center | Pediatrics | 1799 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5561 | 2006-11-28 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on WK PEDIATRIC HEALTHCARE ASSOCIATES.
| 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.