CORNELIUS BOS (NPI# 1821069378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821069378 |
| Entity Type | Individual |
| Full Name | CORNELIUS BOS |
| Credential | MD |
| Practice Address |
2600 Greenwood Rd Shreveport LA 71103-3908 |
| Mailing Address |
Po Box 9600 Dept 09-033 Texarkana TX 75505-9600 |
| Practice Telephone | 3182124550 |
| Mailing Telephone | 8772438416 |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2014-02-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
09662R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1975371 | 05 |
| Street Address |
2600 GREENWOOD RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-3908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972508307 | Mary Cecola | Nurse Anesthetist, Certified Registered | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2005-06-13 |
| 1427675701 | Lakyn Paige Smith | Nurse Practitioner | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2020-07-02 |
| 1730645201 | Willis Knighton Medical Center, Inc. | Clinic/Center | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2019-02-20 |
| 1013497114 | Cross Lake Emergency Group, LLC | Physician Assistant | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2018-08-17 |
| 1417479262 | Kristen Mccoy Keener | Nurse Practitioner | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2017-07-13 |
| 1689110538 | Penny Lynn Ford | Nurse Anesthetist, Certified Registered | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2017-01-17 |
| 1427508456 | Edward Glenn Bernatowicz | Pharmacist | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2016-10-13 |
| 1306237391 | Christina Maxwell | Nurse Anesthetist, Certified Registered | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2015-02-11 |
| 1467841270 | Houston Lacobee | Nurse Anesthetist, Certified Registered | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2015-01-16 |
| 1740688415 | Ana Costea | Emergency Medicine | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2014-12-12 |
| 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801393590 | Sterling Spine, LLC | Radiology | 708 N Ashley Ridge Loop Ste 400, Shreveport, LA 71106-7234 | 2018-04-09 |
| 1992046148 | Benjamin Vickers | Radiology | 8601 Rampart Pl, Shreveport, LA 71106-6227 | 2013-03-13 |
| 1053659672 | Lacy Holmes Williams | Radiology | 416 Travis St, Suite 1200, Shreveport, LA 71101-3282 | 2013-01-17 |
| 1710238100 | Thomas Archie Grant | Radiology | 9392 Stonebriar Cir, Shreveport, LA 71115-3728 | 2012-09-25 |
| 1174569412 | Ginger Auer-baker | Radiology | 708 N Ashley Ridge Loop, Suite #400, Shreveport, LA 71106-7234 | 2006-06-22 |
| 1932108578 | Open Mri of Northwest Louisiana LLC | Radiology | 855 Pierremont Rd, Suite 105, Shreveport, LA 71106-2084 | 2005-07-15 |
| 1548656465 | Evangeline Clinical Services, Inc. | Radiology | 855 Pierremont Rd, Suite 105, Shreveport, LA 71106-2084 | 2015-04-07 |
| 1619396702 | Aya Al Asfari | Radiology | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2014-04-16 |
| 1972947166 | Oluwayemisi M. Ojemakinde | Radiology | 1501 Kings Hwy, Internal Medicine, Shreveport, LA 71103-4228 | 2013-04-18 |
| 1750724555 | Virginia Ann Brown | Radiology | 1501 Kings Hwy, Dept. of Internal Medicine, Shreveport, LA 71103-4228 | 2013-04-10 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on CORNELIUS BOS.
| 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.