HIGHLAND CLINIC, A PROF MED CORP (NPI# 1891168761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891168761 |
| Entity Type | Organization |
| Organization Name | HIGHLAND CLINIC, A PROF MED CORP |
| Practice Address |
1400 E Bert Koun Loop #103 Shreveport LA 71105-5603 |
| Mailing Address |
1455 E Bert Koun Loop Shreveport LA 71105-5634 |
| Practice Telephone | 3182228402 |
| Practice Fax Number | 3182224556 |
| 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 | 207W00000X | Ophthalmology | 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 |
| 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 |
| 1700259678 | Highland Clinic, A Prof Med Corp | Orthopaedic Surgery | 1453 E Bert Koun Loop, #210, Shreveport, LA 71105-6800 | 2015-11-02 |
| 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 |
1400 E BERT KOUN LOOP #103 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5603 |
| 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 | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| 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 Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043744196 | Aigerim B. Saulebayeva | Ophthalmology | 1501 Kings Hwy Bldg 1-201, Shreveport, LA 71103-4228 | 2017-04-16 |
| 1861838989 | James Vernon Ward | Ophthalmology | 413 Trinity Cir, Shreveport, LA 71106-2340 | 2013-05-15 |
| 1871781666 | Karen M'liss Pendleton | Ophthalmology | 6030 Line Ave, Suite 210, Shreveport, LA 71106-2062 | 2007-10-05 |
| 1295828374 | Jerry Welton Drummond | Ophthalmology | 2514 Bert Kouns Ind Loop, Physicians Plaza #9, Shreveport, LA 71118 | 2006-10-02 |
| 1356320568 | Jeffrey M Gosslee | Ophthalmology | 725 N Ashley Ridge Loop, Ste 400, Shreveport, LA 71106 | 2006-01-16 |
| 1235129818 | Donald L Hall | Ophthalmology | 2611 Greenwood Rd, Shreveport, LA 71103-3907 | 2005-10-25 |
| 1427045814 | M. Ashley Wheat-sipes | Ophthalmology | 7843 Youree Dr, Shreveport, LA 71105-5505 | 2005-09-30 |
| 1932105483 | Michael A Holy | Ophthalmology | 1801 Fairfield Ave, Ste 101, Shreveport, LA 71101-4457 | 2005-06-21 |
| 1386649788 | Wilson B Baber | Ophthalmology | 734 N Ashley Ridge Loop, Shreveport, LA 71106-7209 | 2005-06-14 |
| 1255335121 | John D Hinrichsen | Ophthalmology | 1400 E Bert Kouns Loop, Suite #103, Shreveport, LA 71105-5634 | 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.