HIGHLAND CLINIC, A PROF MED CORP (NPI# 1700259678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700259678 |
| Entity Type | Organization |
| Organization Name | HIGHLAND CLINIC, A PROF MED CORP |
| Practice Address |
1453 E Bert Koun Loop #210 Shreveport LA 71105-6800 |
| Mailing Address |
1455 E Bert Koun Loop Shreveport LA 71105-5634 |
| Practice Telephone | 3187984623 |
| Practice Fax Number | 3187984646 |
| Mailing Telephone | 3187984500 |
| Mailing Fax Number | 3187984555 |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2015-12-08 |
| Authorized Official Name | MRS. DEBBIE W. SMITH (ADMINISTRATOR) |
| Authorized Official Telephone | 3187984598 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1038300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897743 | Highland Clinic, A Prof Med Corp | Orthopaedic Surgery | 5025 Shed Rd, Bossier City, LA 71111-5434 | 2020-09-24 |
| 1891168761 | Highland Clinic, A Prof Med Corp | Ophthalmology | 1400 E Bert Koun Loop, #103, Shreveport, LA 71105-5603 | 2015-11-02 |
| 1609297449 | Highland Clinic, A Prof Med Corp | Non-Pharmacy Dispensing Site | 1455 E Bert Kouns Industrial Loop # 101, Shreveport, LA 71105-5634 | 2013-12-20 |
| 1477925063 | Highland Clinic, A Prof Med Corp | Ophthalmology | 471 Ashley Ridge Blvd, Shreveport, LA 71106-7229 | 2015-10-22 |
| 1053315846 | Highland Clinic, A Prof Med Corp | Clinic/Center | 1455 E Bert Kouns Loop, Shreveport, LA 71105-5634 | 2005-06-09 |
| Street Address |
1453 E BERT KOUN LOOP #210 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-6800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588664080 | William Howard Haynie Jr. | Internal Medicine | 1453 E Bert Koun Loop, Ste 112, Shreveport, LA 71105-6800 | 2005-07-26 |
| 1881127090 | Advanced Cardiovascular Specialists | Internal Medicine | 1453 E Bert Koun Loop, Ste 112, Shreveport, LA 71105-6800 | 2017-04-05 |
| 1508315342 | Scott Anthony Leblanc | Physical Therapist | 1453 E Bert Koun Loop, Shreveport, LA 71105-6800 | 2016-09-21 |
| 1851681217 | John Michael Evans | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1453 E Bert Koun Loop, Shreveport, LA 71105-6800 | 2011-04-19 |
| 1295735793 | Ralph Willard Baucum IIi | Internal Medicine | 1453 E Bert Koun Loop, Ste 112, Shreveport, LA 71105-6800 | 2005-07-26 |
| 1093715591 | Albert Nolen Krause | Internal Medicine | 1453 E Bert Koun Loop, Suite 112, Shreveport, LA 71105-6800 | 2005-07-26 |
| 1184624686 | Michael Henry Gooszen | Internal Medicine | 1453 E Bert Koun Loop, Suite 112, Shreveport, LA 71105-6800 | 2005-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255624169 | Wk Orthopedic Specialty Center | Orthopaedic Surgery | 2551 Greenwood Rd Ste 130, Shreveport, LA 71103-3984 | 2011-05-25 |
| 1891013637 | Charles Marion Lobrano IIi | Orthopaedic Surgery | 1500 Line Ave Ste 100, Shreveport, LA 71101-4644 | 2010-05-04 |
| 1346451648 | Oner Ali Khera | Orthopaedic Surgery | 8001 Youree Dr Ste 450, Shreveport, LA 71115-2333 | 2007-05-25 |
| 1225149289 | James Aaron Albright | Orthopaedic Surgery | 3932 Fairfield Ave, Shreveport, LA 71106-1014 | 2006-08-31 |
| 1740209519 | John Joseph Ward | Orthopaedic Surgery | 1512 W Kirby Pl, Department of Orthopaedics, Shreveport, LA 71103-3822 | 2006-07-19 |
| 1841229978 | Cambize Shahrdar, Jr Jr. | Orthopaedic Surgery | 7925 Youree Drive, Suite 200, Shreveport, LA 71105-5127 | 2006-07-01 |
| 1184610271 | James L Zumbrunnen | Orthopaedic Surgery | 7925 Youree Dr, Suite 200, Shreveport, LA 71105-5127 | 2005-09-23 |
| 1598758849 | David D Waddell | Orthopaedic Surgery | 6999 Bickham Rd, Shreveport, LA 71107-8398 | 2005-08-23 |
| 1164427829 | Stephen L. Cox | Orthopaedic Surgery | 1500 Line Ave, Suite 100, Shreveport, LA 71101-4644 | 2005-06-17 |
| 1295739001 | William L Overdyke | Orthopaedic Surgery | 1500 Line Avenue, Suite 100, Shreveport, LA 71101 | 2005-06-09 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
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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.