Active NPI
James Wesley Southern
- Pharmacist
- Shreveport, LA
National Provider Identifier
1104427590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 016772
- Practice address
- 7400 Youree Dr
Shreveport, LA 71105-5536 - Phone
- (318) 798-0566
- NPI assigned
- Nov 3, 2020
- Last updated
- Nov 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 016772 | LA | Primary |
Addresses
Primary practice location
7400 Youree Dr
Shreveport, LA 71105-5536
Mailing address
158 Lore Drive
Stonewall, LA 71078
Phone (318) 210-7258
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016772 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604361600000",
"number": "1104427590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "158 LORE DRIVE",
"city": "STONEWALL",
"state": "LA",
"postal_code": "71078",
"telephone_number": "318-210-7258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 YOUREE DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711055536",
"telephone_number": "318-798-0566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHERN",
"first_name": "JAMES",
"middle_name": "WESLEY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-03",
"last_updated": "2020-11-03",
"certification_date": "2020-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "016772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
- Southern Oaks Properties, LLC (Southern Oaks Nursing & Rehabilitation Center)
- Southern Pediatric Clinic
- Southern Pediatric Clinic
- Southern Pediatric Clinic
- Southern Roots Dentistry LLC (Southern Roots Dentistry)
- Southfield Family Dentistry, Inc.
- Ninta Southichack
- Southland Home Health Services, Inc.
- Southside Chiropractic Clinic LLC
- Southside Foot Clinic of Shreveport Inc a Professional Corporation (The Foot Surgery Center of Shreveport)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.