WILLIS KNIGHTON MEDICAL CENTER INC. (NPI# 1457387508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457387508 |
| Entity Type | Organization |
| Organization Name | WILLIS KNIGHTON MEDICAL CENTER INC. |
| Other Organization Name | LARRY FLAKE, MD |
| Practice Address |
8001 Youree Dr Suite 540 Shreveport LA 71115-2302 |
| Practice Telephone | 3182123810 |
| Practice Fax Number | 3182123815 |
| Mailing Telephone | 3182123810 |
| Mailing Fax Number | 3182123815 |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GREG J. GAVIN (NETWORK ADMINISTRATOR) |
| Authorized Official Telephone | 3182123810 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Larry Flake, MD | Doing Business As Name - Organization |
| Street Address |
8001 YOUREE DR SUITE 540 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71115-2302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952306177 | Stephanie Ann Sockrider | Obstetrics & Gynecology | 8001 Youree Dr, Ste 900, Shreveport, LA 71115-2326 | 2005-06-15 |
| 1376174797 | Jaime Hulsey | Pharmacist | 8001 Youree Dr, Shreveport, LA 71115-2302 | 2020-02-04 |
| 1942857784 | Pam Specialty Hospital of Shreveport LLC | Long Term Care Hospital | 8001 Youree Dr, Shreveport, LA 71115-2302 | 2019-08-26 |
| 1073049995 | Holly Johnson | Nurse Practitioner | 8001 Youree Dr, Suite 600, Shreveport, LA 71115-2302 | 2017-05-11 |
| 1598290249 | Wk Pelvic & Reconstructive Surgery | Urology | 8001 Youree Dr, Suite 370, Shreveport, LA 71115-2302 | 2017-05-01 |
| 1871043836 | Willis-knighton Medical System | General Acute Care Hospital | 8001 Youree Dr, 370, Shreveport, LA 71115-2302 | 2016-10-13 |
| 1013375278 | Wk Center for Neurosurgery At Pierremont | Neurological Surgery | 8001 Youree Dr, Suite 850, Shreveport, LA 71115-2302 | 2016-02-03 |
| 1831579077 | Wk Internal Medicine Specialists | Internal Medicine | 8001 Youree Dr, Suite 550, Shreveport, LA 71115-2302 | 2015-06-03 |
| 1992194500 | Wk Urologic Cancer Care | Urology | 8001 Youree Dr, Suite 350, Shreveport, LA 71115-2302 | 2015-01-20 |
| 1164834206 | Jordan Austin Brice | Anesthesiology | 8001 Youree Dr, Shreveport, LA 71115-2302 | 2014-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740829217 | Bno Surgical Consultants, LLC | Physician Assistant | 303 Captain Hm Shreve Blvd, Shreveport, LA 71115 | 2020-01-02 |
| 1902310899 | Islam LLC | General Acute Care Hospital | 9815 Paragon Ln, Shreveport, LA 71115 | 2017-11-30 |
| 1508304569 | Marcel White | Case Manager/Care Coordinator | 9050 Youree Dr, Apt 105, Shreveport, LA 71115 | 2017-02-09 |
| 1114392784 | Marilyn Sparks | Counselor | 9999 Smitherman Dr Apt 502, Shreveport, LA 71115 | 2015-12-08 |
| 1699031237 | Cody Tingle | Internal Medicine | 8001 Youree Dr Ste 400, Shreveport, LA 71115 | 2012-04-09 |
| 1629366885 | Pankaj Sharma | Psychiatry & Neurology | Department of Neurology, Lsuhsc Shreveport, 1501 Kings Highway, Shreveport, LA 71115 | 2011-07-21 |
| 1396914750 | Lisa L Jawahar | Radiologic Technologist | 429 Creek Holw, Shreveport, LOUISIANA 71115 | 2008-02-29 |
| 1720291412 | Larry Kenneth Robinson Jr. | Dentist | 8856 Youree Dr, Suite C, Shreveport, LA 71115 | 2007-05-08 |
| 1952471609 | Shining Star Professional Services Inc | Social Worker | 9050 Youree Drive, #1004, Shreveport, LA 71115 | 2006-11-09 |
| 1922178854 | Akee Lj Jackson | Social Worker | 9050 Youree Dr. #1004, Shreveport, LA 71115 | 2006-11-08 |
| Find all providers in zip 71115 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922621390 | Partners In Primary Care La PC | Family Medicine | 7551 Youree Dr Ste 11, Shreveport, LA 71105-5533 | 2020-05-20 |
| 1528609104 | Spectra Family Clinic, LLC | Family Medicine | 9300 Mansfield Rd Ste 209, Shreveport, LA 71118-3138 | 2019-10-04 |
| 1922502327 | Courtney Morgan | Family Medicine | 723 Milam St, Shreveport, LA 71101-3507 | 2018-03-20 |
| 1174973317 | Patrick Michael Fitz-gerald | Family Medicine | 731 Coachlight Rd, Shreveport, LA 71106-7205 | 2016-06-19 |
| 1437446341 | Samreena N Sara | Family Medicine | 8835 Line Ave Ste 400a, Shreveport, LA 71106-6722 | 2011-06-30 |
| 1932490554 | Michael Thomas Kitchell | Family Medicine | 1666 E Bert Koun Loop Ste 105, Shreveport, LA 71105-5718 | 2011-04-30 |
| 1831402254 | David J. Colvin Md LLC | Family Medicine | 148 Waters Edge Dr, Shreveport, LA 71106-7774 | 2010-07-15 |
| 1952628802 | Tri Pham | Family Medicine | 133 Charles Ave, Shreveport, LA 71105-3719 | 2010-04-30 |
| 1669799524 | Stephanie James | Family Medicine | 2120 Bert Kouns Industrial Loop Ste M, Shreveport, LA 71118-3355 | 2010-04-30 |
| 1205062965 | Charles Henry Nash | Family Medicine | 5935 Gilbert Dr, Shreveport, LA 71106-2315 | 2009-06-08 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71115 |
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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.