Metabolic Health Restoration

Primary specialty

SpecialistTaxonomy code 174400000X

License

C12615 Issued in LA

Legal business name

METABOLIC HEALTH RESTORATION

Practice address

8575 Fern Ave
Suite 110
Shreveport, LA 71105-5676

Phone

(318) 698-8889

Fax

(318) 698-8893

NPI assigned

Jul 23, 2014

Organization subpart

No

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

Authorized official

Name

Deborah K Adcock, MD

Title

Medical Director

Phone

(318) 698-8889

Specialties & licenses 1

Addresses

Other names 1

• Diabetic Life Pulse of Louisiana, LLC Former legal business name

Locations

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1144638149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 FERN AVE",
            "address_2": "SUITE 110",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055676",
            "telephone_number": "318-698-8889",
            "fax_number": "318-698-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 FERN AVE",
            "address_2": "SUITE 110",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055676",
            "telephone_number": "318-698-8889",
            "fax_number": "318-698-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METABOLIC HEALTH RESTORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-23",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "ADCOCK",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "318-698-8889",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "C12615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetic Life Pulse of Louisiana, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• George Robert Merriman II, M.D.
• Susan Diaz Merry, APRN, FNP-C
• Mesloh Counseling Center, LLC
• Stephanie Leigh Mesloh, M.A., LPC
• John Isles Fraser Messier, PA
• Metamorphosis Counseling Services
• Bruce Deandre Metcalf
• John D Metoyer, CRNA
• Melody Candace Harmony Metoyer
• Mildred Metoyer, BSN, RN

• Specialist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.