GPN-Leesville, LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

GPN-LEESVILLE, LLC

Practice address

1020 W Fertitta Blvd
Leesville, LA 71446-4645

Phone

(337) 239-9041

NPI assigned

Apr 10, 2018

Last updated

Apr 10, 2018By 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

Chris Beddoe

Title

Ceo

Phone

(337) 936-8920

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523318400000",
    "number": "1043717515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 TEXAS ST STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W FERTITTA BLVD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464645",
            "telephone_number": "337-239-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GPN-LEESVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-10",
        "last_updated": "2018-04-10",
        "status": "A",
        "authorized_official_last_name": "BEDDOE",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-936-8920"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Glavan
• Glen D. Hurlston, M.D., Apmc
• Rebecca Godfrey
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• Shawn Patrick Granger, M.D.
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• Great South Management LLC (Deep South Chiropractic Clinic 2)

• Emergency Medicine Physician in Leesville, LA
• Providers in Leesville, LA by specialty
• Emergency Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.