SHRINERS HOSPITALS FOR CHILDREN (NPI# 1568803732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568803732 |
| Entity Type | Organization |
| Organization Name | SHRINERS HOSPITALS FOR CHILDREN |
| Other Organization Name | SHRINERS HOSPITALS FOR CHILDREN (PROFESSIONAL SERVICES) |
| Practice Address |
3100 Samford Ave Shreveport LA 71103-4239 |
| Mailing Address |
Po Box 8500 Lockbox #7642 Philadelphia PA 19178-7642 |
| Practice Telephone | 3182225704 |
| Practice Fax Number | 3184247610 |
| Mailing Telephone | 3182225704 |
| Mailing Fax Number | 3184247610 |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2019-09-20 |
| Authorized Official Name | JERRY G. GANTT (PRESIDENT) |
| Authorized Official Telephone | 8132810300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Shriners Hospitals for Children (Professional Services) | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255461075 | Shriners Hospitals for Children | General Acute Care Hospital | 1275 Fairfax Rd, Salt Lake City, UT 84103-4324 | 2007-03-07 |
| 1508908591 | Shriners Hospitals for Children | General Acute Care Hospital | 3160 Genevea St, Los Angeles, CA 90020 | 2007-02-13 |
| 1669513941 | Shriners Hospitals for Children | General Acute Care Hospital | 815 Market Street, Galveston, TX 77550 | 2007-02-09 |
| 1285250977 | Shriners Hospitals for Children | Clinic/Center | 215 Radio Drive, Suite 100, Woodbury, MN 55125 | 2020-06-18 |
| 1952962011 | Shriners Hospitals for Children | Clinic/Center | 12502 Usf Pine Dr, Tampa, FL 33612-9411 | 2019-06-27 |
| 1477119170 | Shriners Hospitals for Children | Clinic/Center | 12502 Usf Pine Dr, Tampa, FL 33612-9411 | 2019-05-17 |
| 1992289490 | Shriners Hospitals for Children | Clinic/Center | 215 Radio Drive, Suite 100, Woodbury, MN 55125 | 2018-09-20 |
| 1336639780 | Shriners Hospitals for Children | Anesthesiology | 110 Conn Ter, Lexington, KY 40508-3206 | 2018-05-11 |
| 1922597640 | Shriners Hospitals for Children | Anesthesiology | 4400 Clayton Ave, Saint Louis, MO 63110-1624 | 2018-05-08 |
| 1821587544 | Shriners Hospitals for Children | Anesthesiology | 909 S Fair Oaks Ave, Pasadena, CA 91105-2625 | 2018-05-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SHRINERS HOSPITALS FOR CHILDREN | 3101 Sw Sam Jackson Park Rd, Portland, OR 97239-3009 |
| Iowa Business Entities | SHRINERS HOSPITALS FOR CHILDREN | 2900 Rocky Point Dr, Tampa, FL 33607 |
| Oregon Corporations, Companies and Business Names | SHRINERS HOSPITALS FOR CHILDREN | 2900 N Rocky Point Dr, Tampa, FL 33607 |
| Virginia Business Entities | SHRINERS HOSPITALS FOR CHILDREN | 2900 Rocky Point Dr., Tampa, Florida 33607 |
| Vermont Business Registrations | SHRINERS HOSPITALS FOR CHILDREN | 2900 Rocky Point Drive, Tampa, FL 33607 |
| Oklahoma Business Registrations | SHRINERS HOSPITALS FOR CHILDREN | Po Box 31356, Tampa, FL 33631-3356 |
| Street Address |
3100 SAMFORD AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-4239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588634133 | Emily Hummer Naus | Anesthesiology | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2006-01-25 |
| 1104311778 | Amanda Carfagno | Nurse Practitioner | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2018-06-26 |
| 1922596170 | Shriners Hospitals for Children | Anesthesiology | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2018-04-24 |
| 1912303330 | Pediatric Orthotic and Prosthetic Services-southeast, LLC | Prosthetic/Orthotic Supplier | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2014-11-12 |
| 1962751495 | Linda Scoggins Beckermeyer | Nurse Practitioner | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2012-08-30 |
| 1356641799 | Shiela Eileen Sterling | Physical Therapist | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2010-11-02 |
| 1285934620 | Shannon Marie Davis | Physical Therapist | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2010-11-02 |
| 1386944718 | Deborah Banks | Physical Therapist | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2010-11-02 |
| 1659671097 | Natalie Wooley Bomar | Occupational Therapist | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2010-11-02 |
| 1255631594 | Susan Saylors Bryant | Physical Therapist | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2010-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 207XP3100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Pediatric Orthopaedic Surgery |
| An orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones. |
| Notes: Source: American Academy of Pediatrics, www.aap.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164438099 | John A. Fox | Orthopaedic Surgery | 7925 Youree Dr Ste 200, Shreveport, LA 71105-5134 | 2006-07-31 |
| 1740448299 | Janay Mckie | Orthopaedic Surgery | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2008-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083831887 | Clark A Gunderson | Orthopaedic Surgery | 2615 Enterprise Blvd, Lake Charles, LA 70601 | 2007-04-20 |
| 1669715322 | Ryan Patrick Farmer | Orthopaedic Surgery | 4704 Ambassador Caffery Pkwy, Lafayette, LA 70508 | 2013-04-01 |
| 1306193917 | Sushant D Ghate | Orthopaedic Surgery | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2012-08-14 |
| 1760706782 | Mccall G Mcdaniel | Orthopaedic Surgery | 71211 Highway 21, Covington, LA 70433-7121 | 2010-03-19 |
| 1063684314 | John Robert Faust | Orthopaedic Surgery | 7777 Hennessy Blvd Ste 306, Baton Rouge, LA 70808-4365 | 2008-03-27 |
| 1124205372 | Women's & Children's Pediatric Orthopedic Center, LLC | Orthopaedic Surgery | 4630 Ambassador Caffery Pkwy, Suite 408, Lafayette, LA 70508-6949 | 2008-01-29 |
| 1750588836 | Michael Heffernan | Orthopaedic Surgery | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2007-07-02 |
| 1770701898 | David Hawkes Steiner | Orthopaedic Surgery | 506 S 6th St, Leesville, LA 71446-4442 | 2007-04-23 |
| 1538259478 | James Bennett | Orthopaedic Surgery | 1430 Tulane Ave, New Orleans, LA 70112-2632 | 2006-10-13 |
| 1407891963 | Vinitha R Shenava | Orthopaedic Surgery | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2006-06-18 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
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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.