NORTHERN LOUISIANA CARDIAC SERVICES LLC (NPI# 1376055897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376055897 |
| Entity Type | Organization |
| Organization Name | NORTHERN LOUISIANA CARDIAC SERVICES LLC |
| Other Organization Name | ADVANCED HEART AND VASCULAR CENTER |
| Practice Address |
1453 E Bert Kouns Industrial Loop Ste 220 Shreveport LA 71105-6810 |
| Mailing Address |
Po Box 51008 Shreveport LA 71135-1008 |
| Practice Telephone | 3186293170 |
| Practice Fax Number | 3186293171 |
| Mailing Telephone | 3186293170 |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2017-11-02 |
| Authorized Official Name | ISAAC PALMER (BOARD MEMBER) |
| Authorized Official Telephone | 3186815054 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| ADVANCED HEART AND VASCULAR CENTER | Doing Business As Name - Organization |
| Street Address |
1453 E BERT KOUNS INDUSTRIAL LOOP STE 220 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-6810 |
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598390015 | Christus Surgery Center Villages LLC | Clinic/Center | 385 Bert Kouns Industrial Loop Ste 300, Shreveport, LA 71106-8158 | 2020-03-04 |
| 1427384924 | Red River Surgery Center LLC | Clinic/Center | 708 N Ashley Ridge Loop Bldg 400, Shreveport, LA 71106-7234 | 2009-10-19 |
| 1386893758 | Surgical Suites At The Wall Center, LLC | Clinic/Center | 8600 Fern Avenue, Ste. 200, Shreveport, LA 71105 | 2008-09-10 |
| 1659356392 | Laser & Cataract Center of Shreveport LLC | Clinic/Center | 445 Ashley Ridge Blvd, Shreveport, LA 71106 | 2005-12-14 |
| 1174863336 | Slsc Medical Staff | Clinic/Center | 8711 Line Ave, Shreveport, LA 71106-6813 | 2013-02-26 |
| 1144491614 | Ambulatory Surgery Center of Louisiana | Clinic/Center | 385 Bert Kouns Industrial Loop, Bldg 300, Shreveport, LA 71106-8124 | 2008-03-12 |
| 1598804486 | Shreveport Surgery Center Ptrshp | Clinic/Center | 745 Olive St, Suite 100, Shreveport, LA 71104-2246 | 2007-02-06 |
| 1316970916 | Surgical Specialty Center, LLC | Clinic/Center | 1500 Line Ave, Suite 204, Shreveport, LA 71101-4639 | 2006-07-08 |
| 1245215706 | Southside Foot Clinic of Shreveport Inc A Professional Corporation | Clinic/Center | 9308 Mansfield Rd, Suite 300, Shreveport, LA 71118-3134 | 2005-12-07 |
| 1265437743 | Regional Urology Asc LLC | Clinic/Center | 255 Bert Kouns Loop, Shreveport, LA 71106-8150 | 2005-06-20 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on NORTHERN LOUISIANA CARDIAC SERVICES LLC.
| 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.