SHREVEPORT DOCTORS' HOSPITAL (NPI# 1629279468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629279468 |
| Entity Type | Organization |
| Organization Name | SHREVEPORT DOCTORS' HOSPITAL |
| Practice Address |
1130 Louisiana Ave Shreveport LA 71101-3908 |
| Mailing Address |
Po Box 676689 Dallas TX 75267-6689 |
| Practice Telephone | 3182271211 |
| Mailing Telephone | 9727055134 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BRIAN KIRK (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3186784206 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1749150 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124229398 | Shreveport Doctors' Hospital | Rehabilitation Unit | 1130 Louisiana Ave, Shreveport, LA 71101-3908 | 2007-05-29 |
| Street Address |
1130 LOUISIANA AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-3908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457320616 | Mrunalini B Shah | Physical Medicine & Rehabilitation | 1130 Louisiana Ave, Shreveport, LA 71101-3908 | 2006-03-17 |
| 1699966432 | Simba Ventures Hospital La, LLC | Psychiatric Unit | 1130 Louisiana Ave, Shreveport, LA 71101-3908 | 2007-08-07 |
| 1053502294 | Simba Ventures Hospital La, LLC | General Acute Care Hospital | 1130 Louisiana Ave, Shreveport, LA 71101-3908 | 2007-08-05 |
| 1124229398 | Shreveport Doctors' Hospital | Rehabilitation Unit | 1130 Louisiana Ave, Shreveport, LA 71101-3908 | 2007-05-29 |
| 1437210630 | Stephen W. Clark | Nurse Anesthetist, Certified Registered | 1130 Louisiana Ave, Shreveport, LA 71101-3908 | 2006-12-12 |
| 1255492450 | Stephen C Smith | Nurse Anesthetist, Certified Registered | 1130 Louisiana Ave, Shreveport, LA 71101-3908 | 2006-12-12 |
| 1912066556 | Thomas L. Smith | Nurse Anesthetist, Certified Registered | 1130 Louisiana Ave, Shreveport, LA 71101-3908 | 2006-12-08 |
| 1861407298 | Doctors Hospital Er Group | Emergency Medicine | 1130 Louisiana Ave, Shreveport, LA 71101-3908 | 2006-07-31 |
| 1528011673 | Shreveport Doctors Hospital 2003, Ltd. | General Acute Care Hospital | 1130 Louisiana Ave, Shreveport, LA 71101-3908 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235618109 | University Health Shreveport LLC | Psychiatric Unit | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2018-08-10 |
| 1780018838 | Brfhh Shreveport LLC | Psychiatric Unit | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2013-08-26 |
| 1699966432 | Simba Ventures Hospital La, LLC | Psychiatric Unit | 1130 Louisiana Ave, Shreveport, LA 71101-3908 | 2007-08-07 |
| 1912059932 | Willis Knighton Medical Center, Inc. | Psychiatric Unit | 1111 Line Avenue, Shreveport, LA 71101 | 2007-01-18 |
| 1821192162 | Brfhh Shreveport LLC | Psychiatric Unit | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2006-09-08 |
| 1285660134 | Christus Health Northern Louisiana | Psychiatric Unit | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971133 | Start Corporation | Psychiatric Unit | 23251 S Robin Road, Suite 102, Mandeville, LA 70448-7044 | 2020-10-26 |
| 1134365216 | Rural Healthcare Developers of Louisiana LLC | Psychiatric Unit | 2837 Ernest St, Lake Charles, LA 70601-8408 | 2008-12-19 |
| 1831342336 | Sterlington Critical Access Hospital, LLC | Psychiatric Unit | 111 La Hwy 2, Sterlington, LA 71280-3009 | 2008-10-28 |
| 1548452535 | Children's Hospital | Psychiatric Unit | 210 State St Bldg 10, New Orleans, LA 70118-5735 | 2007-08-14 |
| 1649460122 | Hood Memorial Hospital | Psychiatric Unit | 301 West Walnut Street, Amite, LA 70422 | 2007-07-31 |
| 1104980473 | American Legion Hospital | Psychiatric Unit | 300 S Bradford St, Rayne, LA 70578-6961 | 2006-12-21 |
| 1427122969 | Phc-opelousas Lp | Psychiatric Unit | 225 Guidroz, Arnaudville, LA 70512 | 2006-11-17 |
| 1538174347 | East Jefferson General Hospital | Psychiatric Unit | 4200 Houma Boulevard, Metairie, LA 70006-0000 | 2006-07-30 |
| 1801825005 | Hospital Service District # 2 of Lasalle Parish | Psychiatric Unit | 187 Ninth Street, Jena, LA 71342-2780 | 2006-07-01 |
| 1306883384 | Rapides Healthcare System, L.L.C. | Psychiatric Unit | 1610 7th St, Mamou, LA 70554-2299 | 2006-05-31 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
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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.