NPIMap

Individual provider Active NPI

William L Overdyke, MD

  • Orthopaedic Surgery Physician
  • Shreveport, LA
National Provider Identifier
1295739001
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
014596 Issued in LA
Practice address
1500 Line Avenue
Suite 100
Shreveport, LA 71101
Phone
(318) 635-3052
Fax
(318) 635-3072
NPI assigned
Jun 9, 2005
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 014596 LA Primary

Addresses

Primary practice location

1500 Line Avenue
Suite 100
Shreveport, LA 71101

Mailing address

1500 Line Avenue
Suite 100
Shreveport, LA 71101
Phone (318) 635-3052

Other identifiers 3

IdentifierTypeStateIssuer
1053315846OtherLAGROUP NPI NUMBER
1329673MedicaidLA
200016529OtherLARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040430001062 LA Practitioner - Physical Medicine and RehabilitationPractitioner - Orthopedic Surgery 7719975614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Orthopedic Surgery
Education
Louisiana State University School of Medicine in Shreveport, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4900 Medical Dr
Bossier City, LA 71112-4521
Phone (318) 422-0295

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
30.39 of 100Reported as individual
Quality
30
Improvement activities
0
Cost
44.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
014596LAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sportmedica, LLC CurrentSince Jul 14, 2015 Accepting new patients
WK North Orthopedic Clinic PastSince Jan 16, 2006 Accepting new patients
Cornerstone Post Acute Care of Bossier LLC Past Accepting new patients

Locations

4900 Medical Dr
Bossier City, LA 71112
Phone (318) 747-9500

200 N Bryant Ave
Ste 10
Edmond, OK 73034

Organizations & group practices 3

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 10

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1295739001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LINE AVENUE",
            "address_2": "SUITE 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71101",
            "telephone_number": "318-635-3052",
            "fax_number": "318-635-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LINE AVENUE",
            "address_2": "SUITE 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71101",
            "telephone_number": "318-635-3052",
            "fax_number": "318-635-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERDYKE",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "014596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1053315846",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1329673",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200016529",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.