NPIMap

Organization Active NPI

Delta Medical Services

  • PACE Provider Organization
  • Shreveport, LA
National Provider Identifier
1154508364
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
License
11385 Issued in LA
Legal business name
DELTA MEDICAL SERVICES
Practice address
1800 Buckner St
Suite B210
Shreveport, LA 71101-4440
Phone
(318) 459-1600
NPI assigned
Jan 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Authorized official

Name
Doris Mitchell
Title
President/Ceo
Phone
(318) 459-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X 11385 LA Primary

Addresses

Primary practice location

1800 Buckner St
Suite B210
Shreveport, LA 71101-4440

Mailing address

1800 Buckner St
Suite B210
Shreveport, LA 71101-4440

Other identifiers 4

IdentifierTypeStateIssuer
1172367MedicaidLA
1369403MedicaidLA
1368431MedicaidLA
1566331MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Delta Medical Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1154508364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 BUCKNER ST",
            "address_2": "SUITE B210",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BUCKNER ST",
            "address_2": "SUITE B210",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014440",
            "telephone_number": "318-459-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "318-459-1600"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "LA",
            "license": "11385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1172367",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1369403",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1368431",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1566331",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 30, 2008; 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.