Individual provider Active NPI

Georgia Shively Monk, PA-C

  • Physician Assistant
  • Shreveport, LA
National Provider Identifier
1285145706
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
306988 Issued in LA
Practice address
1666 E Bert Kouns Industrial Loop
Shreveport, LA 71105-5714
Phone
(318) 212-3520
Fax
(318) 212-3525
NPI assigned
Oct 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 306988 LA Primary

Addresses

Primary practice location

1666 E Bert Kouns Industrial Loop
Shreveport, LA 71105-5714

Mailing address

1666 E Bert Kouns Industrial Loop
Shreveport, LA 71105-5714
Phone (318) 212-3520

Other practice location 1

7925 Youree Dr
Shreveport, LA 71105-5127
Phone (318) 212-3610

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171214001236 LA Practitioner - Physician Assistant 3072871383 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Louisiana State University School of Medicine in Shreveport, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Urgent Care Center-PierremontGroup PAC ID 8123016946, 39 clinicians

Practice addresses (Care Compare)

1001 Lackland Blvd
Suite 110
Benton, LA 71006-2505
Phone (318) 935-1500

1666 E Bert Kouns Industrial Loop
Suite 105
Shreveport, LA 71105-5718
Phone (318) 212-3520

2520 Bert Kouns Industrial Loop
Suite 105
Shreveport, LA 71118-3130
Phone (318) 212-5520

2600 Greenwood Rd
Shreveport, LA 71103-3908
Phone (318) 212-3520

5751 Shed Rd
Suite 100
Bossier City, LA 71111-5662
Phone (318) 935-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Nov 16, 2020 Accepting new patients
University Health Shreveport LLC Physician Assistant CurrentSince Oct 1, 2018 Accepting new patients
Ochsner Clinic LLC CurrentSince Nov 16, 2020 Accepting new patients
WK Urgent Care Center - Bossier Past Accepting new patients

Locations

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1285145706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055714",
            "telephone_number": "318-212-3520",
            "fax_number": "318-212-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055714",
            "telephone_number": "318-212-3520",
            "fax_number": "318-212-3525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7925 Youree Dr",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711055127",
            "country_code": "US",
            "telephone_number": "318-212-3610",
            "fax_number": "318-212-3672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONK",
        "first_name": "GEORGIA",
        "middle_name": "SHIVELY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "306988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.