DR. JOHN V. MARYMONT (NPI# 1801976212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801976212 |
| Entity Type | Individual |
| Full Name | DR. JOHN V. MARYMONT |
| Credential | MD |
| Practice Address |
1501 Kings Hwy Department of Orthopedics Shreveport LA 71103-4228 |
| Mailing Address |
1512 W Kirby Pl Shreveport LA 71103-3822 |
| Practice Telephone | 3186755000 |
| Mailing Telephone | 3186757636 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2012-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
203714 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | MEDICARE - PTAN | 4P025F600 | 01 |
| LA | 2110080 | 05 |
| Street Address |
1501 KINGS HWY DEPARTMENT OF ORTHOPEDICS |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-4228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801890769 | F Dean Griffen | Surgery | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2005-06-09 |
| 1336747625 | Lana Nasief | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-09 |
| 1558968834 | Dinesh Regalla | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-08 |
| 1588261283 | Divleen Sidhu | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-10-06 |
| 1023624517 | Grace Hoffman | Pharmacist | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-20 |
| 1194330761 | Yousef Hasan | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-10 |
| 1790399277 | Ricardo Murguia Fuentes | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-02 |
| 1013521509 | Tahir Ahmad | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-02 |
| 1376155309 | Ayesha Malik | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-20 |
| 1104438324 | Elleny Gutierrez | Student in an Organized Health Care Education/Training Program | 1501 Kings Hwy, Shreveport, LA 71103 | 2020-08-19 |
| 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 | 207XX0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Foot and Ankle Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: title modified, definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619969342 | James S Lillich | Orthopaedic Surgery | 1500 Line Avenue, Ste 100, Shreveport, LA 71101 | 2005-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467516567 | Meredith Ann Warner | Orthopaedic Surgery | 18161 E Petroleum Dr, Baton Rouge, LA 70809-6104 | 2006-12-21 |
| 1720006687 | Paul E Fenn Jr. | Orthopaedic Surgery | 105 Patriot Ave, Suite 101, Lafayette, LA 70508 | 2006-07-18 |
| 1700817673 | Roger H Ogden II II | Orthopaedic Surgery | 2731 Napoleon Avenue, Southern Orthopaedic Specialists, New Orleans, LA 70115 | 2006-07-06 |
| 1275518110 | Grant Arthur Dona | Orthopaedic Surgery | 1501 Louisville Ave, Monroe, LA 71201-6025 | 2005-12-14 |
| 1811994759 | Christopher Hebert | Orthopaedic Surgery | 108 Rue Louis Xiv, Lafayette, LA 70508-5739 | 2005-07-07 |
| 1679818892 | Center for Innovations In Evaluative Medicine | Orthopaedic Surgery | 18161 E Petroleum Dr, Baton Rouge, LA 70809-6104 | 2012-11-28 |
| 1295025138 | Julie Ann Neumann | Orthopaedic Surgery | 7301 Hennessy Blvd Ste 200, Baton Rouge, LA 70808-4794 | 2011-04-12 |
| 1295782647 | Janet E. Lewis | Orthopaedic Surgery | 501 S Pine St, Deridder, LA 70634-4939 | 2006-05-30 |
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on DR. JOHN V. MARYMONT.
| 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.