KYLE K. RUNNELS (NPI# 1497966907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497966907 |
| Entity Type | Individual |
| Full Name | KYLE K. RUNNELS |
| Credential | M.D. |
| Practice Address |
9091 Ellerbe Rd Suite 200 B Shreveport LA 71106-6738 |
| Practice Telephone | 3188613838 |
| Practice Fax Number | 3188613836 |
| Mailing Telephone | 3188613838 |
| Mailing Fax Number | 3188613836 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2013-10-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084B0040X |
Psychiatry & Neurology Specialization: Behavioral Neurology & Neuropsychiatry |
201837 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 21481 | 05 |
| Street Address |
9091 ELLERBE RD SUITE 200 B |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-6738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801870415 | Stephen M Beene | Specialist | 9091 Ellerbe Rd, Suite 200, Shreveport, LA 71106-6738 | 2005-12-06 |
| 1487918454 | Greg Brown, Md, LLC | Behavioral Analyst | 9091 Ellerbe Rd, Suite 200b, Shreveport, LA 71106-6738 | 2012-06-25 |
| 1932488525 | Gregory P Guerin | Counselor | 9091 Ellerbe Rd, Suite 200 B, Shreveport, LA 71106-6738 | 2011-08-12 |
| 1922235597 | Peter H. Nasser | Dentist | 9091 Ellerbe Rd, Suite 500, Shreveport, LA 71106-6738 | 2009-06-22 |
| 1689768897 | Kenneth Wayne Mouser | Dentist | 9091 Ellerbe Rd, Suite 300, Shreveport, LA 71106-6738 | 2006-10-03 |
| 1619937802 | John G Underwood II | Internal Medicine | 9091 Ellerbe Rd, Ste 200, Shreveport, LA 71106-6738 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| Taxonomy Code | 2084B0040X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Behavioral Neurology & Neuropsychiatry |
| Behavioral Neurology & Neuropsychiatry is a medical subspecialty involving the diagnosis and treatment of neurologically based behavioral issues. |
| Notes: Source: National Uniform Claim Committee. [1/1/2012: new] Additional Resources: American Academy of Neurology, www.aan.com. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093219081 | Neuropsychiatry Services LLC | Psychiatry & Neurology | 7714 La Hwy 700, Kaplan, LA 70548-6121 | 2018-03-22 |
| 1518460211 | Deepblue Wellness LLC | Psychiatry & Neurology | 4421 Conlin St Ste 101, Metairie, LA 70006-2145 | 2018-03-09 |
| 1063849537 | Gensis Center LLC | Psychiatry & Neurology | 11721 Market Place Ave, Baton Rouge, LA 70816-6012 | 2013-09-30 |
| 1295751006 | Terry J Lain | Psychiatry & Neurology | 5610 Read Blvd, New Orleans, LA 70127-3106 | 2006-07-14 |
| 1275079030 | Affinity Health Group, LLC | Psychiatry & Neurology | 920 Oliver Rd, Monroe, LA 71201-5702 | 2017-01-17 |
| 1679582928 | Katherine Hester Smith | Psychiatry & Neurology | 1010 Common St, New Orleans, LA 70112-2401 | 2006-08-05 |
| City | SHREVEPORT |
| Zip Code | 71106 |
Please comment or provide details below to improve the information on KYLE K. RUNNELS.
| 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.