Active NPI
George Samir Nemr Mina, MD
- Interventional Cardiology Physician
- Shreveport, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- MD.207075
- Practice address
- 1541 Kings Hwy
Shreveport, LA 71103-4228 - Phone
- (318) 626-0000
- Fax
- (318) 629-4833
- NPI assigned
- Jun 29, 2011
- Last updated
- Aug 17, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD.207075 | LA | |
| Cardiovascular Disease Physician | 207RC0000X | MD.207075 | LA | |
| Interventional Cardiology Physician | 207RI0011X | MD.207075 | LA | Primary |
Addresses
Primary practice location
1541 Kings Hwy
Shreveport, LA 71103-4228
Mailing address
1512 W Kirby PL
Shreveport, LA 71103-3822
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gmina333311@UmassMemorial.direct-ci.com | ||
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 33 |
| Leg revascularization (restoring blood flow) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD.207075 | LA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lsu Health Sciences Center Shreveport Faculty Group Practice | Internal Medicine | Current | Accepting new patients |
| University Health Shreveport LLC | Past | Accepting new patients | |
| University Health Shreveport LLC | Past | Accepting new patients |
Locations
4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000
1322 Kings Hwy
Fl 2
Shreveport, LA 71103
Phone (318) 626-4072
1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434
1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177
1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287
1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402
Interoperability endpoints
- gmina333311@umassmemorial.direct-ci.com
- gmina768989@direct.ochsner.org
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Shreveport, LA
- NPI 1013374222
Internal Medicine
-
dba Ochsner LSU Health Shreveport
- General Acute Care Hospital
- Shreveport, LA
- NPI 1427536325
-
dba Ochsner LSU Health Shreveport
- Nurse Practitioner
- Shreveport, LA
- NPI 1619443611
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Ochsner LSU Health Shreveport - St. Mary Medical Center
- Women's Hospital
- Shreveport, LA
- NPI 1285253252
-
dba Ochsner LSU Health Shreveport
- General Acute Care Hospital
- Shreveport, LA
- NPI 1427536325
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692230400000",
"number": "1033406996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1512 W KIRBY PL",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711033822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1541 KINGS HWY",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711034228",
"telephone_number": "318-626-0000",
"fax_number": "318-629-4833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINA",
"first_name": "GEORGE",
"middle_name": "SAMIR NEMR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-29",
"last_updated": "2023-08-17",
"certification_date": "2023-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "LA",
"license": "MD.207075",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "LA",
"license": "MD.207075",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "LA",
"license": "MD.207075",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gmina333311@UmassMemorial.direct-ci.com",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016550002",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "55 Lake Ave N",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016550002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.