NPIMap

Organization Active NPI

Louisiana State University Health Sciences Center

  • Speech-Language Pathologist
  • Shreveport, LA
National Provider Identifier
1154461937
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Practice address
3735 Blair Dr
Shreveport, LA 71103-4601
Phone
(318) 813-2962
Fax
(318) 813-2981
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Authorized official

Name
Reva Matthiew Robinson, MBA
Title
Director of Clin MGMT System
Phone
(318) 813-2962

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary
Audiologist-Hearing Aid FitterGroup: 193200000X MULTI-SPECIALTY GROUP 237600000X
Hearing and Speech Clinic/Center 261QH0700X LA
Hearing Aid Equipment 332S00000X

Addresses

Primary practice location

3735 Blair Dr
Shreveport, LA 71103-4601

Mailing address

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 813-2962

Other identifiers 1

IdentifierTypeStateIssuer
1174173MedicaidLA

Other names 2

  • Allied Health Clinics Doing business as
  • Mollie E Webb Speech & Hearing Center Other name

National Provider Directory

National Provider Directory

Locations

3735 Blair Dr
Shreveport, LA 71103
Phone (318) 632-2015

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596153600000",
    "number": "1154461937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-813-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3735 BLAIR DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034601",
            "telephone_number": "318-813-2962",
            "fax_number": "318-813-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "REVA",
        "authorized_official_middle_name": "MATTHIEW",
        "authorized_official_title_or_position": "DIRECTOR OF CLIN MGMT SYSTEM",
        "authorized_official_telephone_number": "318-813-2962",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174173",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allied Health Clinics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mollie E Webb Speech & Hearing Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.