White Clover, LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

WHITE CLOVER, LLC

Practice address

460 Ashley Ridge Blvd
Ste 600
Shreveport, LA 71106-7235

Phone

(318) 861-4226

NPI assigned

Oct 16, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Tamara M Smith

Title

Cfo

Phone

(318) 455-8856

Specialties & licenses 1

Addresses

Other names 1

• White Clover Wellness & Research Center Doing business as

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1164893178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 ASHLEY RIDGE BLVD",
            "address_2": "STE 600",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067235",
            "telephone_number": "318-861-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 ASHLEY RIDGE BLVD",
            "address_2": "STE 600",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067235",
            "telephone_number": "318-861-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE CLOVER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-16",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "318-455-8856",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Clover Wellness & Research Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nettie Whitaker
• Norma L Whitaker, LAC
• Sterice Whitaker
• White Clover Research Foundation
• White Clover, LLC
• White Morris Transport, LLC
• Tawana Michelle White-Perry
• A'Paulo White
• Amanda Kay White, M.S.
• Amberlee J White, OTR

• Physician Assistant in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.