Active NPI
Dmitri Aleksenko, M.D.
- Neurology Physician
- Shreveport, LA
National Provider Identifier
1255718946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 324015
- Practice address
- 1811 E Bert Kouns Industrial Loop
Ste 120
Shreveport, LA 71105-5741 - Phone
- (318) 212-2720
- Fax
- (318) 212-2718
- NPI assigned
- May 1, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neurology Physician | 2084N0400X | 324015 | LA | Primary |
Addresses
Primary practice location
1811 E Bert Kouns Industrial Loop
Ste 120
Shreveport, LA 71105-5741
Mailing address
1811 E Bert Kouns Industrial Loop
Ste 120
Shreveport, LA 71105-5741
Phone (318) 212-2720
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://www.mettles.com/ | Other |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 324015 | LA | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1255718946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP",
"address_2": "STE 120",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711055741",
"telephone_number": "318-212-2720",
"fax_number": "318-212-2718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP",
"address_2": "STE 120",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711055741",
"telephone_number": "318-212-2720",
"fax_number": "318-212-2718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEKSENKO",
"first_name": "DMITRI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-01",
"last_updated": "2021-06-16",
"certification_date": "2021-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "LA",
"license": "324015",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://www.mettles.com/",
"affiliation": "N",
"endpointDescription": "2.16.840.1.113883.3.6037.1",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "10320 Little Patuxent Pkwy Ste 233-02",
"city": "Columbia",
"state": "MD",
"country_code": "US",
"postal_code": "210443313",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.