Individual provider Active NPI

David L Irwin, SLP

  • Speech-Language Pathologist
  • Shreveport, LA
National Provider Identifier
1194749499
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
3735 Blair Dr
Shreveport, LA 71103-4601
Phone
(318) 813-4200
Fax
(318) 813-4217
NPI assigned
Jul 27, 2006
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

3735 Blair Dr
Shreveport, LA 71103-4601

Mailing address

1450 Claiborne Ave
Shreveport, LA 71103-4204
Phone (318) 813-2970

Other practice location 1

1450 Claiborne Ave
Shreveport, LA 71103-4204
Phone (318) 813-2970

Other identifiers 1

IdentifierTypeStateIssuer
1174173MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212003117 LA Practitioner - Qualified Speech Language Pathologist 1658477542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lsuhsc-S School of Allied HealthGroup PAC ID 0840669123, 23 clinicians

Practice addresses (Care Compare)

1450 Claiborne Ave
Shreveport, LA 71103-4204
Phone (318) 813-2972

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lsuhsc-S School of Allied Health Speech-Language Pathologist CurrentSince Jan 30, 2024 Accepting new patients
Louisiana State University Health Sciences Center Shreveport PastSince May 1, 2005 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

1450 Claiborne Ave
Shreveport, LA 71103
Phone (318) 813-2970

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1194749499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 CLAIBORNE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034204",
            "telephone_number": "318-813-2970",
            "fax_number": "318-813-2975"
        },
        {
            "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": "318-813-4200",
            "fax_number": "318-813-4217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Claiborne Ave",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034204",
            "country_code": "US",
            "telephone_number": "318-813-2970",
            "fax_number": "318-813-2975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174173",
            "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, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.