Organization Active NPI

Musculoskeletal Institute of Louisiana, LLC

  • Orthopaedic Surgery Physician
  • Bossier City, LA
National Provider Identifier
1265616130
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
MUSCULOSKELETAL INSTITUTE OF LOUISIANA, LLC
Practice address
2005 Landry Dr
Bossier City, LA 71111
Phone
(318) 752-7850
Fax
(318) 752-7855
NPI assigned
Dec 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Authorized official

Name
Michelle Stillwell
Title
Cfo
Phone
(318) 629-5451

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

2005 Landry Dr
Bossier City, LA 71111

Mailing address

1534 Elizabeth Ave Ste 301
Shreveport, LA 71101-4531
Phone (318) 629-5001

Other practice location 1

1500 Line Ave Ste 100
Shreveport, LA 71101-4644
Phone (318) 635-3052

Other practice location 2

2005 Landry Dr
Bossier City, LA 71111
Phone (318) 752-7850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031215000899 LA Part B Supplier - Clinic/Group Practice 0143127415 Receives reassigned benefits from 31 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bossier City, LA; Shreveport, LA
O20100930031899 LA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0143127415 Practice locations: Bossier City, LA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1500 Line Ave
Fl 1
Shreveport, LA 71101
Phone (318) 635-3052

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Specialists Hospital Shreveport, LLCShreveport, LA, CCN 190278 Hospital 5% Or Greater Direct Ownership Interest (73.68%) Jan 1, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787184000000",
    "number": "1265616130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 ELIZABETH AVE STE 301",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014531",
            "telephone_number": "318-629-5001",
            "fax_number": "318-629-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 LANDRY DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "71111",
            "telephone_number": "318-752-7850",
            "fax_number": "318-752-7855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Line Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711014644",
            "country_code": "US",
            "telephone_number": "318-635-3052",
            "fax_number": "318-635-3072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2005 Landry Dr",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "71111",
            "country_code": "US",
            "telephone_number": "318-752-7850",
            "fax_number": "318-752-7855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MUSCULOSKELETAL INSTITUTE OF LOUISIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A",
        "authorized_official_last_name": "STILLWELL",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "318-629-5451"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

Verify at the official NPI Registry.