Active NPI
David Cooksey, MD
- Dermatology Physician
- Shreveport, LA
National Provider Identifier
1225032121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 012189
- Practice address
- 1455 E Bert Kouns Loop
Shreveport, LA 71105-5634 - Phone
- (318) 798-4677
- Fax
- (318) 798-4417
- NPI assigned
- Jun 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 012189 | LA | Primary |
Addresses
Primary practice location
1455 E Bert Kouns Loop
Shreveport, LA 71105-5634
Mailing address
1455 E Bert Kouns Loop
Shreveport, LA 71105-5634
Phone (318) 798-4677
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1191884 | Medicaid | LA | |
| 070004786 | Other | LA | RAILROAD MEDICARE NUMBER |
| 1053315846 | Other | LA | GROUP NPI NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231718400000",
"number": "1225032121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1455 E BERT KOUNS LOOP",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711055634",
"telephone_number": "318-798-4677",
"fax_number": "318-798-4417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1455 E BERT KOUNS LOOP",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711055634",
"telephone_number": "318-798-4677",
"fax_number": "318-798-4417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOKSEY",
"first_name": "DAVID",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-08",
"last_updated": "2009-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "LA",
"license": "012189",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1191884",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE NUMBER",
"identifier": "070004786",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI NUMBER",
"identifier": "1053315846",
"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 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.