BREATHEAMERICA SHREVEPORT INC (NPI# 1700138781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700138781 |
| Entity Type | Organization |
| Organization Name | BREATHEAMERICA SHREVEPORT INC |
| Practice Address |
463 Ashley Ridge Blvd Suite 100 Shreveport LA 71106-7231 |
| Practice Telephone | 3182213585 |
| Practice Fax Number | 3182279094 |
| Mailing Telephone | 3182213585 |
| Mailing Fax Number | 3182279094 |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2013-08-23 |
| Authorized Official Name | MR. TIMOTHY JAMES MILLER (VP MANAGED CARE) |
| Authorized Official Telephone | 6156657122 |
| Is Organization Subpart | Y |
| Parent Organization Name | BREATHEAMERICA INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | 009735 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
463 ASHLEY RIDGE BLVD SUITE 100 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-7231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164482725 | David A Kaufman | Allergy & Immunology | 463 Ashley Ridge Blvd, Ste 100, Shreveport, LA 71106-7231 | 2006-03-27 |
| 1568789667 | Christopher Robert Phillips | Physical Therapist | 463 Ashley Ridge Blvd, Ste 100, Shreveport, LA 71106-7231 | 2010-04-28 |
| 1598881484 | Kenya Leigh Soto | Speech-Language Pathologist | 463 Ashley Ridge Blvd, Shreveport, LA 71106-7231 | 2007-03-22 |
| 1720050370 | Ashley Ridge Imaging Center, LLC | Clinic/Center | 463 Ashley Ridge Blvd, Suite 200, Shreveport, LA 71106-7231 | 2006-02-07 |
| 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 | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861791592 | Caroline Virginia Caperton | Allergy & Immunology | 2530 Bert Kouns Industrial Loop Ste 112, Shreveport, LA 71118-3153 | 2011-03-21 |
| 1801853106 | Gonzalo Alvarez Del Real | Allergy & Immunology | 1455 E Bert Kouns Industrial Loop # 108, Shreveport, LA 71105-5634 | 2006-04-28 |
| 1164482725 | David A Kaufman | Allergy & Immunology | 463 Ashley Ridge Blvd, Ste 100, Shreveport, LA 71106-7231 | 2006-03-27 |
| 1922533637 | Wk Allergy Asthma & Immunology Center | Allergy & Immunology | 2530 Bert Kouns Industrial Loop, Suite 112, Shreveport, LA 71118-3132 | 2017-05-01 |
| 1780802504 | Healing Grace Internal Medicine & Pediatrics, LLC | Allergy & Immunology | 6821 Pines Rd, Suite 200, Shreveport, LA 71129-2547 | 2007-04-24 |
| 1417966888 | John Moissidis Md and Willis-knighton Medical Center | Allergy & Immunology | 2551 Greenwood Rd, Suite 310, Shreveport, LA 71103-3981 | 2006-08-05 |
| 1053308742 | Ioannis A. Moissidis | Allergy & Immunology | 850 Olive St, Suite B, Shreveport, LA 71104-2162 | 2005-09-29 |
| 1386648129 | Lori R Johnson | Allergy & Immunology | 1455 E Bert Kouns Loop, Shreveport, LA 71105-5634 | 2005-06-09 |
| 1982608659 | Willard F Washburne | Allergy & Immunology | 1455 E Bert Kouns Loop, Shreveport, LA 71105-5634 | 2005-06-09 |
| 1679577340 | Steven C Whited | Allergy & Immunology | 1455 E Bert Kouns Loop, Shreveport, LA 71105-5634 | 2005-06-09 |
| Find all providers in SHREVEPORT | ||||
| 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.