Individual provider Active NPI

Jerel L Raney, M.D.

  • Emergency Medicine Physician
  • Shreveport, LA
National Provider Identifier
1245206077
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
14348R Issued in LA
Practice address
7045 Youree Dr
Shreveport, LA 71105-5108
Phone
(318) 798-3763
Fax
(318) 798-2267
NPI assigned
Feb 23, 2006
Last updated
Sep 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 14348R LA Primary

Addresses

Primary practice location

7045 Youree Dr
Shreveport, LA 71105-5108

Mailing address

7045 Youree Dr
Shreveport, LA 71105-5108
Phone (318) 798-3763

Other identifiers 1

IdentifierTypeStateIssuer
1136905MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081014000708 LA Practitioner - Emergency Medicine 1355419649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Vanderbilt University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cross Lake Emergency Group, LLCGroup PAC ID 5395096440, 60 clinicians

Practice addresses (Care Compare)

2510 Bert Kouns Industrial Loop
Shreveport, LA 71118-3119
Phone (318) 212-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14348RLAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Lake Emergency Group, LLC Emergency Medicine CurrentSince Oct 1, 2018 Accepting new patients
Velocity Care Arkansas PLLC CurrentSince Apr 8, 2013 Accepting new patients
Louisiana Em-1 Medical Services, PC Past Accepting new patients

Locations

11600 Chenal Pkwy
Ste 5
Little Rock, AR 72211
Phone (501) 221-1160

2510 Bert Kouns Industrial Loop
Shreveport, LA 71118
Phone (318) 212-5000

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1245206077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7045 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055108",
            "telephone_number": "318-798-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7045 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055108",
            "telephone_number": "318-798-3763",
            "fax_number": "318-798-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANEY",
        "first_name": "JEREL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "14348R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1136905",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.