South Shreveport Family Medicine, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

SOUTH SHREVEPORT FAMILY MEDICINE, LLC

Practice address

8660 Fern Ave Ste 105
Shreveport, LA 71105-5657

Phone

(318) 797-0009

Fax

(318) 797-0092

NPI assigned

Oct 29, 2010

Organization subpart

No

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

Authorized official

Name

Jon Charles Barnes, FNP

Title

FNP

Phone

(318) 349-6728

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jefferey D Adair, MD

  • Interventional Pain Medicine Physician
  • Shreveport, LA
  • NPI 1780665828
  NPD

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1013217595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 RED BARON DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711153052",
            "telephone_number": "318-349-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8660 FERN AVE STE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055657",
            "telephone_number": "318-797-0009",
            "fax_number": "318-797-0092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHREVEPORT FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-29",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "318-349-6728",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1131831",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Soto-Davila
• Kenya Leigh Soto, CCC SLP
• John Caleist Soud, DO
• South Shreve Medical Supplies, Inc.
• South Shreveport Anesthesia
• South Shreveport Internal Medicine
• Southern Hills LLC
• Southern Kidney Associates PLLC
• Southern Oaks Nursing & Rehabilitation Center, LLC
• Southern Oaks Properties, LLC

• Family Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.