NPIMap

Organization Active NPI

White Clover, LLC

  • Cardiovascular Disease Physician
  • Shreveport, LA
National Provider Identifier
1104281476
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
022377 Issued in LA
Legal business name
WHITE CLOVER, LLC
Practice address
8835 Line Ave Ste 400
Shreveport, LA 71106-6730
Phone
(318) 861-4226
NPI assigned
Dec 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Authorized official

Name
Mrs. Tamara M Smith
Title
Cfo
Phone
(318) 455-8856

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X 022377 LA Primary

Addresses

Primary practice location

8835 Line Ave Ste 400
Shreveport, LA 71106-6730

Mailing address

8835 Line Ave Ste 400
Shreveport, LA 71106-6730
Phone (318) 861-4226

Other names 1

  • White Clover Wellness & Research Center Doing business as

National Provider Directory

National Provider Directory

Locations

8835 Line Ave
Ste 400
Shreveport, LA 71106
Phone (318) 222-0885

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451433600000",
    "number": "1104281476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8835 LINE AVE STE 400",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066730",
            "telephone_number": "318-861-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8835 LINE AVE STE 400",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066730",
            "telephone_number": "318-861-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE CLOVER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "318-455-8856",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "022377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Clover Wellness & Research Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 30, 2015; 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.