Danzell Family Medical Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

013603 Issued in LA

Legal business name

DANZELL FAMILY MEDICAL CLINIC

Practice address

2500 Kings Hwy
Shreveport, LA 71103-3922

Phone

(318) 631-4030

Fax

(318) 631-4031

NPI assigned

Apr 7, 2014

Organization subpart

Yes

Parent organization

DANZELL FAMILY MEDICAL CLINICAs reported in NPPES

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

Authorized official

Name

Mr. John Davis Danzell Jr., M.D.NPI 1821173535

Title

Medical Doctor

Phone

(318) 631-4030

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Danzell Family Medical Clinic

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John D Danzell Jr., MD

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1821173535
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1134548175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033922",
            "telephone_number": "318-631-4030",
            "fax_number": "318-631-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033922",
            "telephone_number": "318-631-4030",
            "fax_number": "318-631-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANZELL FAMILY MEDICAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DANZELL FAMILY MEDICAL CLINIC",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "DANZELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVIS",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "318-631-4030",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "LA",
            "license": "013603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1307891",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Daniels, PT, DPT
• Larry Clyde Daniels, MD
• Margaret Eva Daniels, LPC
• Timothy Francis Danish, MD
• Emily Martinson Dantes, MD
• Jacqueline A. Danzell, LCSW
• Jerome Danzell, MD
• John Danzell
• John D Danzell Jr., MD
• Jillian Danzy

• General Practice Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• General Practice Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.