WK Pediatric Healthcare Associates

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

WK PEDIATRIC HEALTHCARE ASSOCIATES

Practice address

1717 E Bert Kouns Industrial Loop
Shreveport, LA 71105-5561

Phone

(318) 212-2920

Fax

(318) 212-2910

NPI assigned

Aug 5, 2011

Organization subpart

No

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

Authorized official

Name

Greg J Gavin

Title

Network Administrator

Phone

(318) 242-4232

Specialties & licenses 1

Addresses

Practitioners 5

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.

• Monica L Haynes, M.D.

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1750388492
  NPD (past)
• Lynne F Holladay, MD

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1053399410
  NPD (past)
• Zainab Manan, MD

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1306583331
  NPD (past)
• Bruce J Pistorius, M.D.

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1851399265
  NPD (past)
• Ashley McHugh White, MD

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1922504067
  NPD (past)

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

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312502400000",
    "number": "1215216494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055561",
            "telephone_number": "318-212-2920",
            "fax_number": "318-212-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055561",
            "telephone_number": "318-212-2920",
            "fax_number": "318-212-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK PEDIATRIC HEALTHCARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-05",
        "last_updated": "2011-08-05",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NETWORK ADMINISTRATOR",
        "authorized_official_telephone_number": "318-242-4232"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WK Orthopedic Clinic
• WK Orthopedic Specialty Center
• WK Pediatric Eye Specialists
• WK Pediatric Gi Specialists
• WK Pediatric Health & Wellness
• WK Pediatric Intensivist
• WK Pediatric Pulmonology Specialists
• WK Pediatric Surgical Associates
• WK Pelvic & Reconstructive Surgery
• WK Physicians Network

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.