WK PEDIATRIC SURGICAL ASSOCIATES (NPI# 1316386436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316386436 |
| Entity Type | Organization |
| Organization Name | WK PEDIATRIC SURGICAL ASSOCIATES |
| Practice Address |
2508 Bert Kouns Loop Shreveport LA 71118-3133 |
| Practice Telephone | 3182125880 |
| Practice Fax Number | 3182125885 |
| Mailing Telephone | 3182125880 |
| Mailing Fax Number | 3182125885 |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2013-06-24 |
| Authorized Official Name | GREG J GAVIN (NETWORK ADMINISTRATOR) |
| Authorized Official Telephone | 3182124232 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
2508 BERT KOUNS LOOP |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-3133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629076120 | Sreedevi Yerrapragada | Internal Medicine | 2508 Bert Kouns Loop, Suite 400, Shreveport, LA 71118-3133 | 2005-07-08 |
| 1790057735 | Willis-knighton Medical Center, Inc. | Obstetrics & Gynecology | 2508 Bert Kouns Loop, Suite 105, Shreveport, LA 71118-3133 | 2012-02-07 |
| 1114256476 | Wk Shreveport Center for Geriatric Health | Psychiatry & Neurology | 2508 Bert Kouns Loop, Suite 303, Shreveport, LA 71118-3133 | 2009-12-16 |
| 1922231851 | Wk South Shreveport Behavioral Health | Psychiatry & Neurology | 2508 Bert Kouns Loop, Suite 203, Shreveport, LA 71118-3133 | 2009-08-26 |
| 1730311960 | Wk Shreveport Behavioral Wellness Center | Psychiatry & Neurology | 2508 Bert Kouns Loop, Suite 203, Shreveport, LA 71118-3133 | 2009-08-21 |
| 1245487404 | Charles Godfried Otu-nyarko | Pediatrics | 2508 Bert Kouns Loop, Suite 101, Shreveport, LA 71118-3133 | 2008-08-19 |
| 1124283320 | Wk Womens Health Clinic | Obstetrics & Gynecology | 2508 Bert Kouns Loop, Suite 201, Shreveport, LA 71118-3133 | 2008-07-28 |
| 1336302108 | Elizabeth Leroy | Obstetrics & Gynecology | 2508 Bert Kouns Loop, Suite 201, Shreveport, LA 71118-3133 | 2008-07-02 |
| 1386825172 | Wk Frederick and Braud Clinic | Family Medicine | 2508 Bert Kouns Loop, Suite 102, Shreveport, LA 71118-3133 | 2007-11-20 |
| 1336341106 | Lauren H Runnels | Obstetrics & Gynecology | 2508 Bert Kouns Loop, Suite 201, Shreveport, LA 71118-3133 | 2007-06-04 |
| Find all providers in the same location | ||||
| 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 | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689672172 | Donald Lynn Sorrells Jr. | Surgery | 2508 Bert Kouns Industrial Loop, Shreveport, LA 71118-3133 | 2005-07-08 |
| 1689672032 | Mark Frederick Brown | Surgery | One Saint Mary Place, Shreveport, LA 71101-4343 | 2005-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285251884 | A'drianne Dorsey | Surgery | 2742 S Roth Ave, Gonzales, LA 70737-4823 | 2020-06-30 |
| 1427080738 | Kenneth W Falterman | Surgery | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508-6908 | 2006-07-07 |
| 1518923317 | John B Lopoo Jr. | Surgery | 8200 Constantin Blvd Ste 220, Baton Rouge, LA 70809-3481 | 2006-04-21 |
| 1386943579 | Jessica Aya Zagory | Surgery | 1542 Tulane Ave, Rm 734a, New Orleans, LA 70112-2865 | 2011-03-28 |
| 1720247364 | Fabienne Lee Gray | Surgery | 200 Henry Clay Ave, Office of Pediatric Surgery, New Orleans, LA 70118 | 2008-06-09 |
| 1487863627 | Shawn J Stafford | Surgery | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2007-05-22 |
| 1548309156 | Pediatric Surgery of Louisiana, LLC | Surgery | 7777 Hennessy Blvd, Suite 212, Baton Rouge, LA 70808 | 2007-02-06 |
| 1902975543 | Benjamin B. Peeler | Surgery | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2006-11-07 |
| 1801976238 | Mary Brandt | Surgery | 200 Henry Clay Ave, New Orleans, LA 70118-5798 | 2006-10-17 |
| 1144322421 | Timothy William Pettitt | Surgery | 200 Henry Clay Ave, New Orleans, LA 70118 | 2006-09-05 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
Please comment or provide details below to improve the information on WK PEDIATRIC SURGICAL 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.