Craig Chu, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

301868 Issued in LA

Practice address

2508 Bert Kouns Industrial Loop Ste 320
Shreveport, LA 71118-3167

Phone

(318) 212-5990

Fax

(318) 212-5887

NPI assigned

May 13, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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 Pediatric Intensivist

  • Pediatric Critical Care Medicine Physician
  • Shreveport, LA
  • NPI 1023074549

  LA

  Medicare reassignment NPD
• WK South Hospitalists

  • Hospitalist Physician
  • Shreveport, LA
  • NPI 1831357482

  LA

  Medicare reassignment NPD
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  NPD (past)

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1164740262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 BERT KOUNS INDUSTRIAL LOOP STE 320",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183167",
            "telephone_number": "318-212-5990",
            "fax_number": "318-212-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 BERT KOUNS INDUSTRIAL LOOP STE 320",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183167",
            "telephone_number": "318-212-5990",
            "fax_number": "318-212-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-13",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "301868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christus Surgery Center Villages LLC
• Christus Trinity Clinic
• Christus Trinity Clinic
• Amelia Christy, PT, DPT
• Cheng Chu, M.D.
• Chinaemerem Jeffrey Chukwudoro, DO
• Natalia Chunga Iturry, MD
• Elisa Chwoschtschinsky, MD
• Shashank Reddy Cingam, MBBS
• Jonathon Cipoletti, RPH

• All providers in Shreveport, LA
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.