Phoenix Health Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PHOENIX HEALTH SERVICES, LLC

Practice address

2021 Line Ave
Shreveport, LA 71104-2124

Phone

(318) 221-0661

Fax

(318) 221-0662

NPI assigned

Jul 13, 2006

Last updated

Aug 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Suresh K Donepudi, M.D.NPI 1922075035

Title

Owner

Phone

(318) 688-5416

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Suresh Kumar Donepudi, MD

  • Psychiatry Physician
  • Shreveport, LA
  • NPI 1922075035
  Authorized official Same address or phone

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1013932904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 MANSFIELD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182144",
            "telephone_number": "318-688-5416",
            "fax_number": "318-688-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042124",
            "telephone_number": "318-221-0661",
            "fax_number": "318-221-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "DONEPUDI",
        "authorized_official_first_name": "SURESH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-688-5416",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lea Ann Phillips, NP
• Lloyd Phillips, M.D.
• Trandi Lynette Phillips
• Veronica Phillips
• Joonho Phiyo
• Physicians Behavioral Hospital, LLC (Physicians Behavioral Hospital)
• Patricia Pichilingue Reto, MD
• Polly Lynn Pickard
• Vicki Su Pickard, M.S., P.T.
• Jalynn Mar'Dai Pickens

• Mental Health Clinic/Center (Including Community Mental Health Center) in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.