Individual provider Active NPI

Theresa L Rinderle, MD

  • Family Medicine Physician
  • Shreveport, LA
National Provider Identifier
1083619589
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20918 Issued in LA
Practice address
9091 Ellerbe Rd Ste 200
Shreveport, LA 71106
Phone
(318) 681-1630
Fax
(318) 681-1641
NPI assigned
Jun 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.020918 LA
Family Medicine Physician 207Q00000X 20918 LA Primary

Addresses

Primary practice location

9091 Ellerbe Rd Ste 200
Shreveport, LA 71106

Mailing address

9091 Ellerbe Rd Ste 200
Shreveport, LA 71106-6737
Phone (318) 681-1630

Other practice location 1

9220 Ellerbe Rd Ste 700
Shreveport, LA 71106-6709
Phone (318) 681-5282

Other identifiers 6

IdentifierTypeStateIssuer
1K0589OtherLAMEDICARE
B006OtherLATRICARE
080049827OtherLARR MCR
1914533MedicaidLA
2706235006OtherLACIGNA
4519575OtherLAAETNA

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
I20100113000882 LA Practitioner - Family Practice 1850432774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone (318) 681-4138

9220 Ellerbe Rd
700 Christus Primary Care Partners
Shreveport, LA 71106-6709
Phone (318) 681-5282

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20918LAMDFamily Medicine Physician
MD.020918LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C H Wilkinson Physician Network Family Medicine CurrentSince Apr 30, 2018 Accepting new patients
Christus Trinity Clinic Texas Family Medicine CurrentSince Dec 1, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
C H Wilkinson Physician Network CurrentSince Apr 30, 2018 Accepting new patients

Locations

9091 Ellerbe Rd
Ste 200
Shreveport, LA 71106
Phone (318) 681-1630

9220 Ellerbe Rd
Ste 700
Shreveport, LA 71106
Phone (318) 681-5282

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

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: trinderle155515@christushealth.direct-ci.net

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 7

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1083619589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9091 ELLERBE RD STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066737",
            "telephone_number": "318-681-1630",
            "fax_number": "318-681-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9091 ELLERBE RD STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71106",
            "telephone_number": "318-681-1630",
            "fax_number": "318-681-1641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9220 Ellerbe Rd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711066709",
            "country_code": "US",
            "telephone_number": "318-681-5282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RINDERLE",
        "first_name": "THERESA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.020918",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "20918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1K0589",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "B006",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "080049827",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1914533",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2706235006",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4519575",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.