WK RIVER CITIES INTERVENTIONAL PAIN (NPI# 1962447052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962447052 |
| Entity Type | Organization |
| Organization Name | WK RIVER CITIES INTERVENTIONAL PAIN |
| Practice Address |
1811 E Bert Kouns Industrial Loop Suite 300 Shreveport LA 71105-5740 |
| Practice Telephone | 3182123636 |
| Practice Fax Number | 3182123649 |
| Mailing Telephone | 3182123636 |
| Mailing Fax Number | 3182123649 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2012-06-08 |
| Authorized Official Name | GREG J. GAVIN (NETWORK ADMINISTRATOR) |
| Authorized Official Telephone | 3182128085 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1448222 | 05 |
| Street Address |
1811 E BERT KOUNS INDUSTRIAL LOOP SUITE 300 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700881299 | Alan John Borne | Internal Medicine | 1811 E Bert Kouns Industrial Loop, Suite 440, Shreveport, LA 71105-5740 | 2005-06-20 |
| 1871018127 | Tucker L Kifer | Nurse Practitioner | 1811 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5740 | 2017-08-08 |
| 1427505254 | Wk Pierremont Associates In Internal Medicine | Internal Medicine | 1811 E Bert Kouns Industrial Loop, Suite 130, Shreveport, LA 71105-5740 | 2016-09-09 |
| 1235513151 | Brandy Rambin | Nurse Practitioner | 1811 E Bert Kouns Industrial Loop, Suite 110, Shreveport, LA 71105-5740 | 2015-07-10 |
| 1972947034 | Steven D Abney | Psychologist | 1811 E Bert Kouns Industrial Loop, Suite 300, Shreveport, LA 71105-5740 | 2013-04-19 |
| 1568728178 | Jai P Munjampalli | Pain Medicine | 1811 E Bert Kouns Industrial Loop, Suite 300, Shreveport, LA 71105-5740 | 2012-04-09 |
| 1659561082 | Alan J Borne, M D, Apmc | Internal Medicine | 1811 E Bert Kouns Industrial Loop, Suite 440, Shreveport, LA 71105-5740 | 2007-08-01 |
| 1376745794 | Wk Pierremont Pediatrics | Pediatrics | 1811 E Bert Kouns Industrial Loop, Suite 140, Shreveport, LA 71105-5563 | 2007-06-05 |
| 1487681730 | Wendy Mcbride Moses | Family Medicine | 1811 E Bert Kouns Industrial Loop, Suite 400, Shreveport, LA 71105-5740 | 2006-06-26 |
| 1629019047 | Webb Internal Medicine, LLC | Internal Medicine | 1811 E Bert Kouns Industrial Loop, Suite 480, Shreveport, LA 71105-5740 | 2006-06-09 |
| Find all providers in the same location | ||||
| 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 | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346871605 | Park Plaza Surgical Specialists LLC | Anesthesiology | 8731 Park Plaza Dr Ste B, Shreveport, LA 71105-5682 | 2020-01-27 |
| 1336152610 | Sudarshan Manikchand Tanga | Anesthesiology | 8730 Youree Drive, Suite C, Shreveport, LA 71115 | 2006-08-15 |
| 1710466628 | Arklatex Medical Consultants A Medical Corporation | Anesthesiology | 8731 Park Plaza Dr, Shreveport, LA 71105-5682 | 2018-08-10 |
| 1164514774 | Anesthesiology and Pain Management | Anesthesiology | 1666 E Bert Kouns Loop, Suite 125, Shreveport, LA 71105-5714 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114563160 | Richard C Robertson Jr Md LLC | Anesthesiology | 7039 Highway 190 East Service Rd Ste C, Covington, LA 70433-4961 | 2019-11-25 |
| 1275055618 | Northshore Anesthesia and Pain Associates, LLC | Anesthesiology | 4324 Veterans Memorial Blvd # 101, Metairie, LA 70006-5445 | 2017-07-07 |
| 1659639995 | Doctors Medical Center, LLC | Anesthesiology | 3769 Pontchartrain Dr, Suite 1, Slidell, LA 70458-4852 | 2012-04-24 |
| 1811263296 | Alexander F Bowen | Anesthesiology | 2912 Brookwood St, Gretna, LA 70056-7830 | 2012-03-29 |
| 1609191212 | Tod Alan Aust | Anesthesiology | 740 Gause Blvd, Slidell, LA 70458-2840 | 2010-04-07 |
| 1366673626 | Barry Francis Faust Jr. | Anesthesiology | 4500 Clearview Pkwy Ste 200, Metairie, LA 70006-2351 | 2009-08-05 |
| 1295985000 | Southern Pain & Anesthesia Consultants, LLC | Anesthesiology | 64026 Highway 434, Suite 230, Lacombe, LA 70445-5412 | 2008-09-29 |
| 1265616130 | Musculoskeletal Institute of Louisiana, LLC | Anesthesiology | 2005 Landry Dr, Bossier City, LA 71111 | 2007-12-27 |
| 1851582795 | Eric Inman Royster | Anesthesiology | 2801 Napoleon Ave, New Orleans, LA 70115-6915 | 2007-08-06 |
| 1346377595 | Wayne J Celestine IIi | Anesthesiology | 36 Seven Oaks, Marrero, LA 70072 | 2007-02-27 |
| Find all providers with the same taxonomy | ||||
| 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.