NPIMap

Organization Active NPI

Specialists Hospital Shreveport, LLC

  • General Acute Care Hospital
  • Shreveport, LA
National Provider Identifier
1104057694
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
626 Issued in LA
Legal business name
SPECIALISTS HOSPITAL SHREVEPORT, LLC
Practice address
1500 Line Avenue
Suite 206
Shreveport, LA 71101-4639
Phone
(318) 213-3800
Fax
(318) 213-3801
NPI assigned
Jul 31, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Mrs. Kandi G. Moore
Title
Ceo
Phone
(318) 632-6083

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 626 LA Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

1500 Line Avenue
Suite 206
Shreveport, LA 71101-4639

Mailing address

1500 Line Avenue
Suite 206
Shreveport, LA 71101-4639
Phone (318) 213-3800

Other identifiers 1

IdentifierTypeStateIssuer
1702439MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Specialists Hospital of Louisiana4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1104057694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LINE AVENUE",
            "address_2": "SUITE 206",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014639",
            "telephone_number": "318-213-3800",
            "fax_number": "318-213-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LINE AVENUE",
            "address_2": "SUITE 206",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014639",
            "telephone_number": "318-213-3800",
            "fax_number": "318-213-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALISTS HOSPITAL SHREVEPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-31",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KANDI",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-632-6083",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "LA",
            "license": "626",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1702439",
            "state": "LA"
        }
    ],
    "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 May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.