Sophia Tayebeh Shokouh-Amiri, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

311260 Issued in LA

Practice address

1327 Pierre Ave
Shreveport, LA 71103

Phone

(318) 212-8624

Fax

(318) 226-8545

NPI assigned

Apr 23, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sophia Abdehou Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Louisiana State University School of Medicine in Shreveport, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Pierre Ave Community Health Education and Wellness CenterGroup PAC ID 5597743906, 2 clinicians

WK Community Health ClinicGroup PAC ID 9638130065, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

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

• WK Community Health Clinic

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1558393371
  Medicare reassignment Care Compare group NPD
• WK Pierre Ave Community Health Education and Wellness Center

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1881626513
  Medicare reassignment Care Compare group NPD
• WK Urgent Care Center-Pierremont

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1639115132
  Medicare reassignment NPD

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

• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1134516578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-212-8951",
            "fax_number": "318-212-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 PIERRE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71103",
            "telephone_number": "318-212-8624",
            "fax_number": "318-226-8545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1666 E Bert Koun Loop Ste 105",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711055718",
            "country_code": "US",
            "telephone_number": "318-212-3520",
            "fax_number": "318-212-3525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 Hilry Huckaby III Ave.",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711074702",
            "country_code": "US",
            "telephone_number": "318-221-1001",
            "fax_number": "318-221-1044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4864 Jackson St",
            "address_2": "Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712026400",
            "country_code": "US",
            "telephone_number": "318-330-7620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOKOUH-AMIRI",
        "first_name": "SOPHIA",
        "middle_name": "TAYEBEH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "311260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2387707",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOPHIA",
            "last_name": "ABDEHOU",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leslie Brooks Shinpoch, CRNA
• Faith Olivia Shipley
• Bethany Longino Shirley, APRN, NP-C
• Juliette Shivers, NUTRION PROFESSIONAL
• Hosein M Shokouh-Amiri, M.D.
• Andrew Blake Sholl, M.D.
• Bryce Shonka
• Wylie Lee Shores, R.PH.
• Virginia W Short, MD
• Kaitlyn Shermae Shorter

• Family Medicine Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.