Individual provider Active NPI

Kwabena Asafo-Agyei, MD

  • Family Medicine Physician
  • Shreveport, LA
National Provider Identifier
1073998092
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
310904 Issued in LA
Practice address
1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone
(318) 681-4500
NPI assigned
Jul 21, 2015
Last updated
Dec 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 310904 LA Primary
Internal Medicine Physician 207R00000X 310904 LA

Addresses

Primary practice location

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800

Mailing address

120 Brentwood Commons Way Ste 510
Brentwood, TN 37027-2028
Phone (615) 371-4442

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181001002902 LA Practitioner - Internal Medicine 4688977820 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
310904LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Louisiana Physicians, LLC Internal Medicine CurrentSince Jan 13, 2024 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Family Medicine CurrentSince Sep 27, 2018 Accepting new patients
Cogent Healthcare of Texas, PA Family Medicine CurrentSince Oct 15, 2022 Accepting new patients
Sound Inpatient Physicians of Texas I, Inc Family Medicine Past Accepting new patients

Locations

2531 Viking Dr
Bossier City, LA 71111
Phone (318) 681-7000

4200 Nelson Rd
Lake Charles, LA 70605
Phone (318) 474-6370

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1073998092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BRENTWOOD COMMONS WAY STE 510",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272028",
            "telephone_number": "615-371-4442",
            "fax_number": "615-810-8952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711056800",
            "telephone_number": "318-681-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASAFO-AGYEI",
        "first_name": "KWABENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-21",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "310904",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "310904",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.