Individual provider Active NPI

Carmell Lenert-Williams, MD

  • Emergency Medicine Physician
  • Shreveport, LA
National Provider Identifier
1184838393
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.203095 Issued in LA
Practice address
9300 Mansfield Rd
Suite 110
Shreveport, LA 71118-3155
Phone
(318) 629-3763
NPI assigned
May 9, 2007
Last updated
Jun 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD20395 LA
Emergency Medicine Physician 207P00000X MD.203095 LA Primary
Emergency Medicine Physician 207P00000X P2480 TX

Addresses

Primary practice location

9300 Mansfield Rd
Suite 110
Shreveport, LA 71118-3155

Mailing address

9300 Mansfield Rd
Suite 110
Shreveport, LA 71118-3155
Phone (318) 629-3763

Other identifiers 1

IdentifierTypeStateIssuer
1888389MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090828000531 LA Practitioner - Emergency Medicine 9335294289 Reassigns benefits to 1 organization
I20120919000097 TX Practitioner - Emergency Medicine 9335294289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cross Lake Emergency Group, LLCGroup PAC ID 5395096440, 60 clinicians

Practice addresses (Care Compare)

8001 Youree Dr
Shreveport, LA 71115-2302
Phone (318) 212-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD20395LAMDSpecialist
MD.203095LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Care Specialists Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Louisiana Em-1 Medical Services, PC Past Accepting new patients

Locations

323 E Hawkins Pkwy
Longview, TX 75605
Phone (903) 315-2000

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

811 S Washington Ave
Marshall, TX 75670
Phone (903) 315-1488

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1184838393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 MANSFIELD RD",
            "address_2": "SUITE 110",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183155",
            "telephone_number": "318-629-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 MANSFIELD RD",
            "address_2": "SUITE 110",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183155",
            "telephone_number": "318-629-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENERT-WILLIAMS",
        "first_name": "CARMELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "MD20395",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.203095",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P2480",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1888389",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.