Individual provider Active NPI

Thomas Duddy, FNP

  • Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1053130583
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
237606 Issued in LA
Practice address
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 626-0000
NPI assigned
Oct 10, 2024
Last updated
Apr 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 237606 LA Primary

Addresses

Primary practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1935 W Jordan St
Shreveport, LA 71103-2916
Phone (318) 799-2145

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
I20241122001241 LA Practitioner - Nurse Practitioner 0547795999 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000

1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
237606LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Aug 4, 2025 Accepting new patients
Council for Advancement of Social Service and Education CurrentSince Oct 8, 2024 Accepting new patients
Council for Advancement of Social Service and Education Current Accepting new patients
Council for Advancement of Social Service and Education CurrentSince Oct 8, 2024 Accepting new patients
MDB Behavioral Health Services LLC Past Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

2113 Airline Dr
Ste 100
Bossier City, LA 71111
Phone (318) 519-3088

2120 Airline Dr
Bossier City, LA 71111
Phone (318) 688-3350

907 Polk St
Mansfield, LA 71052
Phone (318) 688-3350

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1560 Irving Pl
Shreveport, LA 71101
Phone (318) 212-1194

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1641 E 70th St
Ste 300
Shreveport, LA 71105
Phone (318) 626-0037

2120 Bert Kouns Industrial Loop
Ste A
Shreveport, LA 71118
Phone (318) 686-9986

149 Stone Creek Rd
Stonewall, LA 71078
Phone (318) 688-3350

Organizations & group practices 7

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.

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": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1053130583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 W JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711032916",
            "telephone_number": "318-799-2145"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDDY",
        "first_name": "THOMAS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-10",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "237606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.