Individual provider Active NPI

Garrett Williams

  • Physician Assistant
  • Shreveport, LA
National Provider Identifier
1043946155
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2751 Albert L Bicknell Dr Ste 5C
Shreveport, LA 71103-3943
Phone
(318) 227-9777
NPI assigned
Jul 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2751 Albert L Bicknell Dr Ste 5C
Shreveport, LA 71103-3943

Mailing address

2751 Albert L Bicknell Dr Ste 5C
Shreveport, LA 71103-3943

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230216001557 LA Practitioner - Physician Assistant 3678945854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians

Practice addresses (Care Compare)

1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone (337) 289-7374

4212 W Congress St
Lafayette, LA 70506-6765

Hospital & facility affiliations

  • Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lafayette Health Ventures Inc CurrentSince Jan 20, 2025 Accepting new patients
Lafayette Health Ventures, Inc CurrentSince Jan 20, 2025 Accepting new patients

Locations

210 Champagne Blvd
Breaux Bridge, LA 70517
Phone (337) 332-2178

4212 W Congress St
Ste 3100
Lafayette, LA 70506
Phone (337) 703-3201

155 Hospital Dr
Ste 201
Lafayette, LA 70503
Phone (337) 234-7777

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1043946155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR STE 5C",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR STE 5C",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033943",
            "telephone_number": "318-227-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "GARRETT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.