WILLIS-KNIGHTON MEDICAL CENTER, INC. (NPI# 1437441698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437441698 |
| Entity Type | Organization |
| Organization Name | WILLIS-KNIGHTON MEDICAL CENTER, INC. |
| Other Organization Name | WK REGIONAL ORTHOPEDIC AND SPORTS MEDICINE |
| Practice Address |
2520 Bert Kouns Loop Suite 105 Shreveport LA 71118-3130 |
| Mailing Address |
1202 Louisiana Ave Shreveport LA 71101-3910 |
| Practice Telephone | 3182125886 |
| Practice Fax Number | 3182125889 |
| Mailing Telephone | 3182125886 |
| Mailing Fax Number | 3182125889 |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2011-12-21 |
| Authorized Official Name | GREG J. GAVIN (NETWORK ADMINISTRATOR) |
| Authorized Official Telephone | 3182128780 |
| Is Organization Subpart | Y |
| Parent Organization Name | WILLIS-KNIGHTON MEDICAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WK Regional Orthopedic and Sports Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790057735 | Willis-knighton Medical Center, Inc. | Obstetrics & Gynecology | 2508 Bert Kouns Loop, Suite 105, Shreveport, LA 71118-3133 | 2012-02-07 |
| 1215129507 | Willis-knighton Medical Center, Inc. | Obstetrics & Gynecology | 2300 Hospital Dr, Suite 140, Bossier City, LA 71111-2394 | 2007-08-10 |
| 1568498608 | Willis-knighton Medical Center, Inc. | Internal Medicine | 2514 Bert Kouns Loop, Suite 6, Shreveport, LA 71118-3146 | 2006-06-23 |
| 1396789749 | Willis-knighton Medical Center, Inc. | Otolaryngology | 2300 Hospital Dr, Suite 320, Bossier City, LA 71111-2394 | 2006-06-16 |
| 1679515118 | Willis-knighton Medical Center, Inc. | Internal Medicine | 2400 Hospital Dr, Suite 350, Bossier City, LA 71111-2385 | 2006-06-11 |
| Street Address |
2520 BERT KOUNS LOOP SUITE 105 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-3130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003809211 | Lea Bonifacio Penales | Pediatrics | 2520 Bert Kouns Loop, Suite 215, Shreveport, LA 71118-3130 | 2005-08-24 |
| 1497047963 | Wk South Orthopedic Clinic | Orthopaedic Surgery | 2520 Bert Kouns Loop, Suite 105, Shreveport, LA 71118-3130 | 2011-05-03 |
| 1003116682 | Kimberly J Bonts | Nurse Practitioner | 2520 Bert Kouns Loop, Suite 215, Shreveport, LA 71118-3130 | 2010-10-28 |
| 1407896285 | Kirk W Cofran Md and Willis-knighton Medical Center | Family Medicine | 2520 Bert Kouns Loop, Suite 102, Shreveport, LA 71118-3130 | 2006-06-08 |
| 1194777441 | Kirk W. Cofran | Family Medicine | 2520 Bert Kouns Loop, Suite 102, Shreveport, LA 71118-3130 | 2006-05-16 |
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255624169 | Wk Orthopedic Specialty Center | Orthopaedic Surgery | 2551 Greenwood Rd Ste 130, Shreveport, LA 71103-3984 | 2011-05-25 |
| 1891013637 | Charles Marion Lobrano IIi | Orthopaedic Surgery | 1500 Line Ave Ste 100, Shreveport, LA 71101-4644 | 2010-05-04 |
| 1346451648 | Oner Ali Khera | Orthopaedic Surgery | 8001 Youree Dr Ste 450, Shreveport, LA 71115-2333 | 2007-05-25 |
| 1225149289 | James Aaron Albright | Orthopaedic Surgery | 3932 Fairfield Ave, Shreveport, LA 71106-1014 | 2006-08-31 |
| 1740209519 | John Joseph Ward | Orthopaedic Surgery | 1512 W Kirby Pl, Department of Orthopaedics, Shreveport, LA 71103-3822 | 2006-07-19 |
| 1841229978 | Cambize Shahrdar, Jr Jr. | Orthopaedic Surgery | 7925 Youree Drive, Suite 200, Shreveport, LA 71105-5127 | 2006-07-01 |
| 1184610271 | James L Zumbrunnen | Orthopaedic Surgery | 7925 Youree Dr, Suite 200, Shreveport, LA 71105-5127 | 2005-09-23 |
| 1598758849 | David D Waddell | Orthopaedic Surgery | 6999 Bickham Rd, Shreveport, LA 71107-8398 | 2005-08-23 |
| 1164427829 | Stephen L. Cox | Orthopaedic Surgery | 1500 Line Ave, Suite 100, Shreveport, LA 71101-4644 | 2005-06-17 |
| 1295739001 | William L Overdyke | Orthopaedic Surgery | 1500 Line Avenue, Suite 100, Shreveport, LA 71101 | 2005-06-09 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
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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.