WK Breast Health & Surgical Center

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

WK BREAST HEALTH & SURGICAL CENTER

Practice address

7843 Youree Dr
Shreveport, LA 71105-5505

Phone

(318) 212-8780

Fax

(318) 212-6752

NPI assigned

Aug 11, 2016

Last updated

Aug 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Greg J Gavin

Title

Network Administrator

Phone

(318) 212-8780

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572

  Member Of

  NPD member

Practitioners 1

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.

• Julie A Cupp, M.D.

  • Surgical Oncology Physician
  • Shreveport, LA
  • NPI 1275742470

  Surgery

  Medicare reassignment NPD

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1295289932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7843 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055505",
            "telephone_number": "318-212-8780",
            "fax_number": "318-212-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7843 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055505",
            "telephone_number": "318-212-8780",
            "fax_number": "318-212-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK BREAST HEALTH & SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NETWORK ADMINISTRATOR",
        "authorized_official_telephone_number": "318-212-8780"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WK Advanced Laparoscopic and Robotic Surgery Specialists
• WK Advanced Surgery Center
• WK Allergy Asthma & Immunology Center
• WK Ark-la-Tex Neonatology
• WK Behavioral Health Services
• WK Care for Kids Clinic
• WK Center for Endocrinology and Diabetes
• WK Center for Neurosurgery at Pierremont
• WK Center for Pediatric Gastroenterology
• WK Center for Pediatrics - South

• Surgery Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.