Active NPI
Richard Lee Wigle, MD
- Trauma Surgery Physician
- Shreveport, LA
National Provider Identifier
1295759850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Trauma Surgery Physician
- License
- 05539R
- Practice address
- 1501 Kings Hwy
Shreveport, LA 71103-4228 - Phone
- (318) 675-5000
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 11
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | G1230 | TX | |
| Surgery Physician | 208600000X | G28185 | CA | |
| Surgery Physician | 208600000X | 25673 | NC | |
| Surgery Physician | 208600000X | 9525 | MS | |
| Surgery Physician | 208600000X | 15769 | SC | |
| Surgery Physician | 208600000X | 33847 | MN | |
| Surgery Physician | 208600000X | 98-198 | NM | |
| Surgery Physician | 208600000X | 025209 | WA | |
| Surgery Physician | 208600000X | M7531 | ID | |
| Trauma Surgery Physician | 2086S0127X | 05539R | LA | Primary |
| Trauma Surgery Physician | 2086S0127X | 50898 | WI |
Addresses
Primary practice location
1501 Kings Hwy
Shreveport, LA 71103-4228
Mailing address
1512 W Kirby PL
Shreveport, LA 71103-3822
Phone (318) 675-5177
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1032824 | Medicaid | LA | |
| 4K995F600 | Other | LA | MEDICARE - PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15769 | SC | MD | Clinical Social Worker |
| 025209 | WA | MD | Ophthalmology Physician |
| G28185 | CA | MD | Surgery Physician |
| M7531 | ID | MD | Surgery Physician |
| 9525 | MS | MD | Surgery Physician |
| 25673 | NC | MD | Surgery Physician |
| 98-198 | NM | MD | Surgery Physician |
| G1230 | TX | MD | Surgery Physician |
| 05539R | LA | MD | Trauma Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Hospital District Inc. | Past | Accepting new patients | |
| United Hospital District Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Rural Health Clinic/Center
- Fairmont, MN
- NPI 1144984766
-
- Critical Access Hospital
- Blue Earth, MN
- NPI 1952307688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343606400000",
"number": "1295759850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1512 W KIRBY PL",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711033822",
"telephone_number": "318-675-5177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 KINGS HWY",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711034228",
"telephone_number": "318-675-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGLE",
"first_name": "RICHARD",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2012-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "G1230",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G28185",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "25673",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MS",
"license": "9525",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "15769",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "33847",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NM",
"license": "98-198",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "025209",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "ID",
"license": "M7531",
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "LA",
"license": "05539R",
"primary": true
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "WI",
"license": "50898",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1032824",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE - PTAN",
"identifier": "4K995F600",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.