Injurymd, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

INJURYMD, LLC

Practice address

1715 Marycrest Ave Ste 200
Shreveport, LA 71101-5074

Phone

(318) 751-9100

Fax

(318) 751-9101

NPI assigned

Mar 19, 2019

Organization subpart

No

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

Authorized official

Name

Samuel David Huckabee

Title

Coo

Phone

(318) 751-9100

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• James Curtis Lyons, PT

  • Physical Medicine & Rehabilitation Physician
  • Shreveport, LA
  • NPI 1487201257
  NPD (past)

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1104385095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 HOLLI RD",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710066700",
            "telephone_number": "318-751-9100",
            "fax_number": "318-751-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 MARYCREST AVE STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711015074",
            "telephone_number": "318-751-9100",
            "fax_number": "318-751-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INJURYMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "HUCKABEE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "318-751-9100"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD.017817",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Ing
• Patrick Ingraffia
• Kristofer Ingram
• Ingram'S Nutrition Consultations
• Brent E Ingvardsen, CRNA
• Mary Inman, ACNPC-AG
• Inner Quality Transportation Services
• Inner Space LLC
• Innerlight Wellness, LLC
• Innovative Senior Solutions, LLC

• Clinic/Center in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.