Edward Ronald Samper, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

05522R Issued in LA

Practice address

1666 E Bert Kouns Industrial Loop
Suite 105
Shreveport, LA 71105-5714

Phone

(318) 212-3520

Fax

(318) 212-3525

NPI assigned

Jul 1, 2006

Last updated

Sep 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• WK Urgent Care Center - Bossier

  • Family Medicine Physician
  • Bossier City, LA
  • NPI 1982640884
  NPD (past)

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1306875570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 E BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "SUITE 105",
            "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",
            "address_2": "SUITE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055714",
            "telephone_number": "318-212-3520",
            "fax_number": "318-212-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPER",
        "first_name": "EDWARD",
        "middle_name": "RONALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "05522R",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "05522R",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "LA",
            "license": "0522R",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.05522R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1351741",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sam R Silverblatt, OD Apmc
• Sam's Club Optical (Sam's Club Optical 30-8273)
• Hrishikesh Samant, M.D.
• Samaritan Counseling Center
• Christina Ruth Sammons, MD
• Carliss Sampognaro
• Gabriel Sampognaro, MD
• Langley Sampognaro, MD
• Navdeep S Samra
• Sams East Inc (Sams Pharmacy 10-8273)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.