Individual provider Active NPI

Amanda Eades

  • Acute Care Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1285408906
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
231615 Issued in LA
Practice address
2727 Hearne Ave
Shreveport, LA 71103-3917
Phone
(318) 631-6400
NPI assigned
Nov 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 231615 LA Primary

Addresses

Primary practice location

2727 Hearne Ave
Shreveport, LA 71103-3917

Mailing address

8713 Pinehaven Dr
Keithville, LA 71047-9774

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
I20240215003794 LA Practitioner - Nurse Practitioner 5799129938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WKMC Cardiovascular ConsultantsGroup PAC ID 0941420061, 34 clinicians

Practice addresses (Care Compare)

2727 Hearne Ave
Suite 301
Shreveport, LA 71103-3918
Phone (318) 631-6400

Hospital & facility affiliations

  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
231615LAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WKMC Cardiovascular Consultants CurrentSince Jan 7, 2024 Accepting new patients

Locations

2400 Hospital Dr
Ste 350
Bossier City, LA 71111
Phone (318) 212-7902

102 S Monroe St
Minden, LA 71055
Phone (318) 377-3425

1809 Northpointe Ln
Ste 130
Ruston, LA 71270

2727 Hearne Ave
Ste 301
Shreveport, LA 71103

2727 Hearne Ave
Shreveport, LA 71103
Phone (318) 212-4791

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

8001 Youree Dr
Ste 740
Shreveport, LA 71115
Phone (318) 212-3830

2508 Bert Kouns Industrial Loop
Ste 105
Shreveport, LA 71118
Phone (318) 688-1204

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1285408906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8713 PINEHAVEN DR",
            "city": "KEITHVILLE",
            "state": "LA",
            "postal_code": "710479774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 HEARNE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033917",
            "telephone_number": "318-631-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADES",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "231615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.