Carson Elizabeth Shetley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA200181 Issued in LA

Practice address

1666 E Bert Kouns Industrial Loop Ste 105
Shreveport, LA 71105-5718

Phone

(318) 212-3520

Fax

(318) 212-3525

NPI assigned

Nov 15, 2007

Last updated

Jan 7, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Urgent Care Center-PierremontGroup PAC ID 8123016946, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• WK Urgent Care Center-Pierremont

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1639115132
  Medicare reassignment Care Compare group
• Louisiana State University Health Sciences Center

  dba LSU Health Shreveport

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1417992249
  Medicare reassignment NPD
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222
  Medicare reassignment
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment
• University Health Shreveport LLC

  dba Ochsner LSU Health Shreveport

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1619443611
  Medicare reassignment
• Ochsner Clinic LLC

  dba Diabetes Prevention Program

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  NPD
• Ochsner Clinic LLC

  dba Ochsner Clinic Elmwood

  • General Practice Physician
  • Jefferson, LA
  • NPI 1760668537
  NPD
• WK Urgent Care Center - Bossier

  • Family Medicine Physician
  • Bossier City, LA
  • NPI 1982640884
  NPD (past)

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1033390398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 E BERT KOUNS INDUSTRIAL LOOP STE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055718",
            "telephone_number": "318-212-3520",
            "fax_number": "318-212-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 E BERT KOUNS INDUSTRIAL LOOP STE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055718",
            "telephone_number": "318-212-3520",
            "fax_number": "318-212-3525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6841 Fern Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711054175",
            "country_code": "US",
            "telephone_number": "318-868-2273",
            "fax_number": "318-868-4219",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1541 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-626-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHETLEY",
        "first_name": "CARSON",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA200181",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA07206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nastarsha Sherman
• Jessica Sherrill, LMSW
• Sherry Campbell FNP and Willis-Knighton Medical Center
• Melissa Melanie Sheth, MD
• Mithil Nimish Sheth
• Viraj Shetty, MD
• Claire Shidler
• Raynell Shield
• Carlina Shields
• Shining Star Professional Services Inc

• Physician Assistant in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.