WK North Laparoscopic Surgical Associates

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

WK NORTH LAPAROSCOPIC SURGICAL ASSOCIATES

Practice address

2751 Albert L Bicknell Dr
Suite 3D
Shreveport, LA 71103-3920

Phone

(318) 221-4755

Fax

(318) 424-3642

NPI assigned

Jun 26, 2013

Organization subpart

No

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

Authorized official

Name

Greg J Gavin

Title

Network Administrator

Phone

(318) 212-4232

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Willis Knighton Medical Center, Inc.

  dba WK Renal Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Shreveport, LA
  • NPI 1003020579

  Member Of

  NPD member

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark H Smith, MD

  • Surgery Physician
  • Shreveport, LA
  • NPI 1104036458
  Medicare reassignment Care Compare group NPD
• Mason Tauer Garfield, PA-C

  • Physician Assistant
  • Shreveport, LA
  • NPI 1548076656
  Medicare reassignment Care Compare group
• Charles R. Byrd, M.D.

  • Surgery Physician
  • Shreveport, LA
  • NPI 1912966771
  Medicare reassignment NPD
• Kasi Lively

  • Student in an Organized Health Care Education/Training Program
  • Shreveport, LA
  • NPI 1699222190
  Medicare reassignment
• Christian Lococo, PA-S

  • Physician Assistant
  • Haughton, LA
  • NPI 1659022135
  Medicare reassignment
• Mary Emily May

  • Surgical Physician Assistant
  • Shreveport, LA
  • NPI 1528082781
  Medicare reassignment
• Sarah K Tucci, PA-C

  • Physician Assistant
  • Shreveport, LA
  • NPI 1982989265
  NPD
• Forrest Holt Wright, M.D.

  • Surgery Physician
  • Shreveport, LA
  • NPI 1770675282
  NPD (past)
• Paul Derek Ware, MD

  • Surgery Physician
  • Gulfport, MS
  • NPI 1053374041
  NPD (past)

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1114367976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR",
            "address_2": "SUITE 3D",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033920",
            "telephone_number": "318-221-4755",
            "fax_number": "318-424-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR",
            "address_2": "SUITE 3D",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033920",
            "telephone_number": "318-221-4755",
            "fax_number": "318-424-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK NORTH LAPAROSCOPIC SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NETWORK ADMINISTRATOR",
        "authorized_official_telephone_number": "318-212-4232"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WK Neurosurgical Associates
• WK Neurovascular Neurosurgery
• WK North Dermatology Clinic
• WK North Gynecology Clinic
• WK North Hospitalists Group
• WK North Laparoscopic Surgical Associates
• WK North Orthopedic Clinic
• WK North Pulmonary & Critical Care
• WK North Shreveport Family Medicine
• WK Northwest Internal Medicine (Willis Knighton Internal Medicine Pierremont Suite 550)

• Surgery Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.