Organization Active NPI

Wellness Pass by Luraguiz MD

  • Family Medicine Physician
  • Shreveport, LA
National Provider Identifier
1265138226
Registry record updated Jun 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLNESS PASS BY LURAGUIZ MD
Practice address
1534 Elizabeth Ave Ste 401
Shreveport, LA 71101-4531
Phone
(318) 431-8613
Fax
(318) 314-2203
NPI assigned
Feb 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2023

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

Authorized official

Name
Natalia Luraguiz, MDNPI 1639465065
Title
Owner
Phone
(318) 426-8351

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1534 Elizabeth Ave Ste 401
Shreveport, LA 71101-4531

Mailing address

1534 Elizabeth Ave Ste 401
Shreveport, LA 71101-4531
Phone (318) 431-8613

Other identifiers 1

IdentifierTypeStateIssuer
19D1055958OtherLACLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230522000252 LA Part B Supplier - Clinic/Group Practice 4385000165 Receives reassigned benefits from 1 practitioner
Practice locations: Shreveport, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2284151Wellness Pass LLC1534 Elizabeth Ave, Suite 401, Shreveport, LA 71101Certificate of waiverJun 18, 2027

National Provider Directory

National Provider Directory

Locations

1534 Elizabeth Ave
Ste 401
Shreveport, LA 71101
Phone (318) 431-8613

Practitioners & affiliated clinicians

Practitioners 7

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": "1675209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687564800000",
    "number": "1265138226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 ELIZABETH AVE STE 401",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014531",
            "telephone_number": "318-431-8613",
            "fax_number": "318-314-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1534 ELIZABETH AVE STE 401",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014531",
            "telephone_number": "318-431-8613",
            "fax_number": "318-314-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS PASS BY LURAGUIZ MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-06-24",
        "certification_date": "2023-06-24",
        "status": "A",
        "authorized_official_last_name": "LURAGUIZ",
        "authorized_official_first_name": "NATALIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-426-8351",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "19D1055958",
            "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 Jun 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.