Individual provider Active NPI

Kevin Gallagher, MD

  • Hematology & Oncology Physician
  • Shreveport, LA
National Provider Identifier
1275776718
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
204735 Issued in LA
Practice address
510 E Stoner Ave
Shreveport, LA 71101-4243
Phone
(318) 221-8411
NPI assigned
Apr 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 204735 LA Primary

Addresses

Primary practice location

510 E Stoner Ave
Shreveport, LA 71101-4243

Mailing address

510 E Stoner Ave
Shreveport, LA 71101-4243
Phone (318) 221-8411

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
I20160108000468 LA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 4082916911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Hematology Oncology AssociatesGroup PAC ID 5597779959, 9 clinicians

Practice addresses (Care Compare)

2600 Kings Hwy
Suite 340
Shreveport, LA 71103-3951
Phone (318) 212-8620

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.53 of 100Reported as apm
Quality
81.42
Promoting interoperability
94.6
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204735LAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Hematology Oncology Associates Hematology & Oncology CurrentSince May 1, 2022 Accepting new patients

Locations

2600 Kings Hwy
Ste 340
Shreveport, LA 71103
Phone (318) 212-3702

Organizations & group practices 1

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 6

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": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1275776718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E STONER AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014243",
            "telephone_number": "318-221-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E STONER AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014243",
            "telephone_number": "318-221-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-14",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "LA",
            "license": "204735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.