Individual provider Active NPI

Mary McFerren, PA-C

  • Medical Physician Assistant
  • Shreveport, LA
National Provider Identifier
1114924404
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
A10356 Issued in LA
Practice address
1811 E Bert Kouns Industrial Loop Ste 120
Shreveport, LA 71105-5741
Phone
(318) 212-2720
Fax
(318) 212-2718
NPI assigned
Jul 1, 2005
Last updated
Jul 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X A10356 LA Primary

Addresses

Primary practice location

1811 E Bert Kouns Industrial Loop Ste 120
Shreveport, LA 71105-5741

Mailing address

1811 E Bert Kouns Industrial Loop Ste 120
Shreveport, LA 71105-5741
Phone (318) 212-2720

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151015000532 LA Practitioner - Physician Assistant 1759690639 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
WK Pierremont Neurology ClinicGroup PAC ID 4082033287, 6 clinicians

Practice addresses (Care Compare)

1811 E Bert Kouns Industrial Loop
Suite 200
Shreveport, LA 71105-5766
Phone (318) 212-2720

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
A10356LAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Clinic, a Prof Med Corp CurrentSince Feb 4, 2019 Accepting new patients
Highland Clinic, a Prof Med Corp CurrentSince Feb 4, 2019 Accepting new patients

Locations

1455 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 300-3643

1455 E Bert Kouns Industrial Loop
#200
Shreveport, LA 71105

Interoperability endpoints

  • Direct secure messaging: mmcferren@direct.wkhs.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1114924404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP STE 120",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055741",
            "telephone_number": "318-212-2720",
            "fax_number": "318-212-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP STE 120",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055741",
            "telephone_number": "318-212-2720",
            "fax_number": "318-212-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFERREN",
        "first_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "A10356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.