NPIMap

Organization Active NPI

Willis Knighton Medical Center, Inc.

Doing business as WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
National Provider Identifier
1003968579
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
232-B Issued in LA
Legal business name
WILLIS KNIGHTON MEDICAL CENTER, INC.
Doing business as
WK Bossier Health Center
Practice address
2400 Hospital Dr
Bossier City, LA 71111-2385
Phone
(318) 212-7003
Fax
(318) 212-7005
NPI assigned
Jan 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stacy H Alexander
Title
Controller
Phone
(318) 212-4877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 232-B LA Primary

Addresses

Primary practice location

2400 Hospital Dr
Bossier City, LA 71111-2385

Mailing address

PO Box 32600
Shreveport, LA 71130-2600
Phone (318) 212-7000

Other names 1

  • WK Bossier Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080630000328 LA Part A Provider - Hospital 0143110585 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shreveport, LA; Bossier City, LA; Benton, LA
O20220209000536 LA Part B Supplier - Intensive Cardiac Rehabilitation 0143110585 Practice locations: Bossier City, LA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1003968579. Details of each certification follow.

Hospital certification: CCN 190111

Legal name
WILLIS KNIGHTON MEDICAL CENTER, INC.
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Sep 27, 1967
Last certification
Nov 23, 2025
Beds
926
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 10, 1949 in LA
Enrollment address
2600 Greenwood Road
Shreveport, LA 71103-3908
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Hospital certification: CCN 190236

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
WILLIS KNIGHTON BOSSIER HEALTH CENTER
Certification status
Terminated Voluntary: merger or closure, Oct 1, 2017
Provider type (POS)
Hospital – Short-term
Participating since
Jul 16, 1996
Last certification
Aug 6, 2016
Beds
166
Ownership / control type
Private (not for profit)
Facility address
2400 Hospital Dr
Bossier City, LA 71111

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Willis Knighton Medical CenterCCN 190111 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1001 Lackland Blvd
Ste 200
Benton, LA 71006
Phone (318) 935-1570

2300 Hospital Dr
Ste 340
Bossier City, LA 71111
Phone (318) 212-7461

2510 Bert Kouns Ind Loop
Ste 103
Shreveport, LA 71118
Phone (318) 212-5910

2600 Kings Hwy
Shreveport, LA 71103
Phone (318) 212-4639

2600 Kings Hwy
Ste 120
Shreveport, LA 71103
Phone (318) 212-8241

616 E Flournoy Lucas Rd
Shreveport, LA 71115
Phone (318) 212-4697

815 S Pine St
#C
Vivian, LA 71082
Phone (318) 212-4180

1000 Amsterdam Ave
New York, NY 10025
Phone (212) 523-4330

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Pierre Blanchard Individual Corporate DirectorTrustee Nov 1, 1983
Peggy Gavin Individual Corporate OfficerSenior Vice-President Jan 1, 2016
W-2 Managing EmployeeSenior Vice-President Jan 1, 2016
Mary Jane Ward Individual Corporate OfficerDirector of Decision Support Aug 1, 2014
W-2 Managing EmployeeDirector of Decision Support Aug 1, 2014
Lamar P. Pugh Individual Corporate DirectorTrustee Dec 14, 2021
Terri Smith Individual OtherSystem Accountant Sep 30, 2013
Eugene Bryson Individual Corporate DirectorTrustee May 27, 2014
Raymond J. Lasseigne Individual Corporate DirectorTrustee Jun 28, 2021
James K Elrod Individual Corporate DirectorBoard Member Aug 1, 1981
Jason E Cobb Individual Corporate Officer Jan 1, 2023
Margaret Elrod Individual Corporate OfficerSenior Vice-President Jan 1, 2016
W-2 Managing EmployeeSenior Vice-President Jan 1, 2016
Elaine J Simpkins Individual Corporate Director Jun 2, 2015
Richard H Sale Individual Corporate DirectorTrustee Jan 28, 2014
Danielle Faris Individual Corporate DirectorCorp Director of Hosp. Complianc May 1, 2022
W-2 Managing EmployeeCorp Director of Hosp. Complianc May 1, 2022
Frank B Hughes Individual Corporate DirectorTrustee - Chairman of the Board May 1, 1996
Jerry a Fielder Individual Corporate OfficerPresident Nov 28, 2017
W-2 Managing EmployeeChief Executive Officer Nov 28, 2017
Brian Crawford Individual Corporate Director Jan 9, 2019
W-2 Managing Employee Jan 9, 2019
Deborah D. Olds Individual Corporate Officer Feb 21, 2023

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Progressive Care CenterShreveport, LA, CCN 195136 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Trustee of the SNF
Adp of the SNF		 Sep 20, 1985
Jul 1, 2007
Jul 30, 2025
D Gregory Bell MD and Willis-Knighton Medical CenterCoushatta, LA, CCN 193895 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 2007

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

Affiliated clinicians 1,134

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,134

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003968579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32600",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711302600",
            "telephone_number": "318-212-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HOSPITAL DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112385",
            "telephone_number": "318-212-7003",
            "fax_number": "318-212-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIS KNIGHTON MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "318-212-4877"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "LA",
            "license": "232-B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WK Bossier Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bossier City, LA

Sources for this page

Verify at the official NPI Registry.