NPIMap

Organization Active NPI

Louisiana State University Health Sciences Center

Doing business as LSUHSC-S Department of Anesthesiology

  • Anesthesiology Physician
  • Shreveport, LA
National Provider Identifier
1235174061
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
142 Issued in LA
Legal business name
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Doing business as
LSUHSC-S Department of Anesthesiology
Practice address
1501 Kings Hwy
Lsuhsc-S Department of Anesthesiology
Shreveport, LA 71103-4228
Phone
(318) 675-7737
Fax
(318) 675-5666
NPI assigned
Jun 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Melanie Hardegree Sotak, MHSA
Title
Director of Managed Care
Phone
(318) 675-7737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 142 LA Primary

Addresses

Primary practice location

1501 Kings Hwy
Lsuhsc-S Department of Anesthesiology
Shreveport, LA 71103-4228

Mailing address

1501 Kings Hwy
Lsuhsc-S Department of Anesthesiology
Shreveport, LA 71103-4228
Phone (318) 675-7737

Other identifiers 1

IdentifierTypeStateIssuer
1946087MedicaidLA

Other names 1

  • LSUHSC-S Department of Anesthesiology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Edwin K Jones15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235174061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "LSUHSC-S DEPARTMENT OF ANESTHESIOLOGY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-7737",
            "fax_number": "318-675-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "LSUHSC-S DEPARTMENT OF ANESTHESIOLOGY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-7737",
            "fax_number": "318-675-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOTAK",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "HARDEGREE",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "318-675-7737",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1946087",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LSUHSC-S Department of Anesthesiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.