NICOLETTE HUMPHRIES (NPI# 1891938239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891938239 |
| Entity Type | Individual |
| Full Name | NICOLETTE HUMPHRIES |
| Credential | MD |
| Practice Address |
2518 Bert Kouns Ind. Loop Shreveport LA 71118-3112 |
| Practice Telephone | 3182125437 |
| Practice Fax Number | 3182125825 |
| Mailing Telephone | 3182125437 |
| Mailing Fax Number | 3182125825 |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2012-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 204992 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
2518 BERT KOUNS IND. LOOP |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-3112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620784 | Wk Center for Pediatric Gastroenterology | Pediatrics | Wk Center for Pediatric Gastroenterology, 2530 Bert Kouns Industrial Loop, Ste 113, Shreveport, LA 71118 | 2019-10-11 |
| 1306302443 | Diamond Marie Willis | Case Manager/Care Coordinator | 9403 Mansfield Rd., Shreveport, LA 71118 | 2019-02-13 |
| 1194224469 | Latosa Hall | Case Manager/Care Coordinator | 9007 Letha Loop, Shreveport, LA 71118 | 2018-02-01 |
| 1902321623 | Bersheika Lashay Player | Counselor | 9403 Mansfield Road, Shreveport, LA 71118 | 2017-08-03 |
| 1518487149 | Clarke Jackson | Case Manager/Care Coordinator | 9730 Baird Rd Apt 2310, Shreveport, LA 71118 | 2017-06-24 |
| 1770010449 | Darrie'l Smith | Counselor | 2715 Mackey, Shreveport, LA 71118 | 2017-05-12 |
| 1760917041 | Delilah Wells | Case Manager/Care Coordinator | 9005 Walker Rd Apt 722, Shreveport, LA 71118 | 2017-04-25 |
| 1790229664 | We Care Transporttion Services LLC | Secured Medical Transport (VAN) | 2529 Summer Grove Dr, Shreveport, LA 71118 | 2016-12-13 |
| 1063955128 | Commanisha Smith | Social Worker | 2715 Mackey Place, Shreveport, LA 71118 | 2016-11-22 |
| 1023560802 | Yasmin Newman | Counselor | 9812 West Trails End, Shreveport, LA 71118 | 2016-10-27 |
| Find all providers in zip 71118 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619311438 | Amanda Vice Haynie | Pediatrics | 2225 Line Avenue, Mid City Pediatrics, Shreveport, LA 71104 | 2013-04-23 |
| 1487913976 | Greg M Oji | Pediatrics | 2508 Bert Kouns Industrial Loop Ste 320, Shreveport, LA 71118-3154 | 2012-05-03 |
| 1497011001 | Tamara Lynn Moore | Pediatrics | 1811 E Bert Kouns Industrial Loop Ste 140, Shreveport, LA 71105-5741 | 2012-04-09 |
| 1316228984 | Choice Pediatrics, LLC | Pediatrics | 6930 Fern Ave, Suite 150, Shreveport, LA 71105-4100 | 2011-09-08 |
| 1598077323 | Virginia Homza Carter | Pediatrics | 909 Olive St, Shreveport, LA 71104 | 2010-07-09 |
| 1407042435 | Hester Suh | Pediatrics | 2709 Mackey Ln, Shreveport, LA 71118-2556 | 2007-09-24 |
| 1639203367 | Suyah M Loud | Pediatrics | 4140 Hollywood Ave, Suite B-2, Shreveport, LA 71109-7818 | 2007-03-15 |
| 1891833869 | Holliway Medical Clinic LLC | Pediatrics | 3824 Hearne Ave, Shreveport, LA 71103 | 2007-02-02 |
| 1134295520 | D Gene Mack Jr Md and Willis-knighton Medical Center | Pediatrics | 1799 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5561 | 2006-11-28 |
| 1669582052 | Wee Care Pediatrics & Kid Med Clinic | Pediatrics | 4571 N Market, Shreveport, LA 71107 | 2006-08-30 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
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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.