Skin Surgery Specialists

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

MD.205964 Issued in LA

Legal business name

SKIN SURGERY SPECIALISTS

Practice address

8575 Business Park Dr
Shreveport, LA 71105-5655

Phone

(678) 448-8276

NPI assigned

Feb 10, 2013

Organization subpart

No

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

Authorized official

Name

Dr. James Keane, M.D.NPI 1427221704

Title

Owner/Administrator

Phone

(678) 448-8276

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Cooper Keane, M.D.

  • Procedural Dermatology Physician
  • Little Rock, AR
  • NPI 1427221704

  LA

  Medicare reassignment NPD Authorized official
• Joshua Michael Ward

  • Physician Assistant
  • Little Rock, AR
  • NPI 1982940516
  NPD (past)

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

{
    "created_epoch": "1360454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374105600000",
    "number": "1083953137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10884 DAUPHINE ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 BUSINESS PARK DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055655",
            "telephone_number": "678-448-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN SURGERY SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-10",
        "last_updated": "2013-07-18",
        "status": "A",
        "authorized_official_last_name": "KEANE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "678-448-8276",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "LA",
            "license": "MD.205964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deepasulochana Sivasankaraganesan, D.M.D
• SJC Transport, LLC
• Skeesick & Williams, LLC
• Kelly Lee Skeesick, LPC, LMFT, NCC
• Kimberly Lynn Skidmore, M.D.
• Robert Skinner
• Skinpath Diagnostics LLC
• Ivan Skocibusic, RT (R)
• Sky Blu Medical Transportation Service Inc
• Skyline Management Group

• Procedural Dermatology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Procedural Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.