PENNINGTON FACIAL PLASTICS, LLC (NPI# 1619405404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619405404 |
| Entity Type | Organization |
| Organization Name | PENNINGTON FACIAL PLASTICS, LLC |
| Practice Address |
345 Drexel Dr Shreveport LA 71106-2305 |
| Practice Telephone | 5057153338 |
| Mailing Telephone | 5055142609 |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2017-05-24 |
| Authorized Official Name | LINDSEY PENNINGTON (SOLE MBR) |
| Authorized Official Telephone | 5057153338 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
205826 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2144464 | 05 |
| Street Address |
345 DREXEL DR |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-2305 |
| 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 | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134411507 | Lindsey Alexander Pennington | Otolaryngology | 1501 Kings Hwy, Otolaryngology, Shreveport, LA 71103-4228 | 2011-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225377856 | James J Lanasa Jr Md Pmc | Otolaryngology | 2223 Quail Run Dr., Ste E, Baton Rouge, LA 70808 | 2013-02-01 |
| 1659662625 | Clyde Edward Landrum | Otolaryngology | 41 Shadows Bend, New Iberia, LA 70563 | 2011-04-26 |
| 1598891806 | David Malcom Doan | Otolaryngology | 15814 Professional Plaza, Hammond, LA 70403-1453 | 2007-02-23 |
| 1952480634 | Ruth Marianne Owens | Otolaryngology | 3900 Veterans Memorial Blvd Ste 200, Metairie, LA 70002-5634 | 2006-11-03 |
| 1497709307 | Harold G Bienvenu IIi | Otolaryngology | 711 S Ryan St, Ste # 100, Lake Charles, LA 70601-5785 | 2006-05-22 |
| 1477502474 | Stephen Eric Metzinger | Otolaryngology | 3223 8th St, Suite 200, Metairie, LA 70002-1623 | 2006-05-08 |
| 1053722785 | Khoobehi & Associates, LLC | Otolaryngology | 3901 Veterans Memorial Blvd, Metairie, LA 70002-5602 | 2014-05-15 |
| 1538312848 | Robert Glynn Peden | Otolaryngology | 533 Bolivar St, Suite 566, New Orleans, LA 70112-1349 | 2008-10-30 |
| 1306004460 | Rizwan Aslam | Otolaryngology | 1430 Tulane Ave, Sl-59, New Orleans, LA 70112-2632 | 2008-05-27 |
| 1003080201 | Parker Anthony Velargo | Otolaryngology | 2633 Napoleon Ave, Ste: 920, New Orleans, LA 70115-6357 | 2008-04-17 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
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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.