Active NPI
Stephen Ross Patton, MD
- Nephrology Physician
- Shreveport, LA
National Provider Identifier
1093700692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 11546R
- Practice address
- 2501 Greenwood Rd
Shreveport, LA 71103-3905 - Phone
- (318) 631-1584
- Fax
- (318) 635-8322
- NPI assigned
- Sep 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 11546R | LA | Primary |
Addresses
Primary practice location
2501 Greenwood Rd
Shreveport, LA 71103-3905
Mailing address
1800 Buckner St
Suite C120
Shreveport, LA 71101-4440
Phone (318) 227-8899
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1661686 | Medicaid | LA | |
| 390005506 | Other | RAILROAD MEDICARE | |
| A003 | Other | CHAMPUS | |
| 3100019 | Other | UNITED HEALTHCARE | |
| 721404303PA1 | Other | OCHSNER | |
| 057675301 | Other | TX | MEDICAID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11546R | LA | MD | Nephrology Physician |
Interoperability endpoints
- stephenpatton@nln.allscriptsdirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1093700692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 BUCKNER ST",
"address_2": "SUITE C120",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711014440",
"telephone_number": "318-227-8899",
"fax_number": "318-222-0407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 GREENWOOD RD",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711033905",
"telephone_number": "318-631-1584",
"fax_number": "318-635-8322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTON",
"first_name": "STEPHEN",
"middle_name": "ROSS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-20",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "LA",
"license": "11546R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1661686",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "390005506",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "A003",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "3100019",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCHSNER",
"identifier": "721404303PA1",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "057675301",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.