JCT Medical Consulting

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

016884 Issued in LA

Legal business name

JCT MEDICAL CONSULTING

Doing business as

JCT Medical/Russell W. Tynes MD

Practice address

460 Ashley Ridge Blvd Ste 500
Shreveport, LA 71106-7228

Phone

(318) 212-1610

Fax

(866) 455-7515

NPI assigned

Sep 19, 2007

Last updated

Apr 29, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Russell W. Tynes, MDNPI 1851323810

Title

Medical Director

Phone

(318) 212-1610

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• JCT MEDICAL/RUSSELL W. TYNES MD Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Russell Wayne Tynes, MD

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1851323810
  Medicare reassignment NPD Authorized official
• Carla Cunningham Tynes, RN

  • Medical-Surgical Registered Nurse
  • Shreveport, LA
  • NPI 1568074565
  NPD

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1205022647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 ASHLEY RIDGE BLVD STE 500",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067228",
            "telephone_number": "318-212-1610",
            "fax_number": "866-455-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 ASHLEY RIDGE BLVD STE 500",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067228",
            "telephone_number": "318-212-1610",
            "fax_number": "866-455-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCT MEDICAL CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "TYNES",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "318-212-1610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "LA",
            "license": "016884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1351661",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JCT MEDICAL/RUSSELL W. TYNES MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasdip Jawanda
• Chatura Davanmini Jayasinghepatirane, MD
• Thomas Edward Jaynes, CRNA
• Beth Nicole Jayroe, PA-C
• JC Express Transportation
• Carlo Jean Baptiste
• Jeanne Street, PHD, Appc
• Elizabeth Jee
• Jefferey Douglas Adair MD (Arklatex Spine)
• Edwin Jefferson

• Medical Specialty Clinic/Center in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Medical Specialty Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.