Ivan Skocibusic, RT (R)

Primary specialty

Radiography Radiologic TechnologistTaxonomy code 2471C3402X

License

561226 Issued in LA

Practice address

5552 Northwood South Rd
Shreveport, LA 71107-9263

Phone

(318) 205-2667

NPI assigned

Apr 17, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1776384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1124962352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5552 NORTHWOOD SOUTH RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711079263",
            "telephone_number": "318-205-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5552 NORTHWOOD SOUTH RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711079263",
            "telephone_number": "318-205-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOCIBUSIC",
        "first_name": "IVAN",
        "credential": "RT (R)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-17",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "LA",
            "license": "561226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiography Radiologic Technologist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Radiography Radiologic Technologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; 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.