NPIMap

Individual provider Active NPI

Louis Victor Crenshaw II, NP C

  • Nurse Practitioner
  • Pineville, LA
National Provider Identifier
1114994746
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP04196 Issued in LA
Practice address
12805 Highway 28 E
Suite B
Pineville, LA 71360-0734
Phone
(318) 466-5151
Fax
(318) 466-3535
NPI assigned
Mar 2, 2006
Last updated
Apr 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN089438 LA
Nurse Practitioner 363L00000X AP04196 LA Primary

Addresses

Primary practice location

12805 Highway 28 E
Suite B
Pineville, LA 71360-0734

Mailing address

12805 Highway 28 E
Suite B
Pineville, LA 71360-0734
Phone (318) 466-5151

Other identifiers 2

IdentifierTypeStateIssuer
1151581MedicaidLA
P00014189OtherLARAILROAD MEDICARE-PALMETT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080513000758 LA Practitioner - Nurse Practitioner 8022187301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Louisiana Quick Care LLCGroup PAC ID 1355668401, 7 clinicians

Practice addresses (Care Compare)

12805 Hwy 28 E
Suite B
Pineville, LA 71360-0708
Phone (318) 466-5151

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP04196LAMDNurse Practitioner
RN089438LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Quick Care LLC CurrentSince Feb 13, 2015 Accepting new patients
SPG Capital Partners, LLC Past Accepting new patients
Mid State Orthopaedic & Sports Medicine Center, LLC Past Accepting new patients
Mid State Orthopaedic & Sports Medicine Center LLC Past Accepting new patients
Crossroads-Holloway Health Clinic LLC PastSince May 24, 2016 Accepting new patients

Locations

12805 Highway 28 E
Ste B
Pineville, LA 71360
Phone (318) 466-5151

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Louisiana Quick Care LLCPineville, LA, CCN 193906 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 13, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1114994746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12805 HIGHWAY 28 E",
            "address_2": "SUITE B",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713600734",
            "telephone_number": "318-466-5151",
            "fax_number": "318-466-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 HIGHWAY 28 E",
            "address_2": "SUITE B",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713600734",
            "telephone_number": "318-466-5151",
            "fax_number": "318-466-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "LOUIS",
        "middle_name": "VICTOR",
        "name_suffix": "II",
        "credential": "NP C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN089438",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP04196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1151581",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-PALMETT",
            "identifier": "P00014189",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, LA

Sources for this page

Verify at the official NPI Registry.