NPIMap

Individual provider Active NPI

Joseph R. Tynes, MD

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1306880778
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
025002 Issued in LA
Practice address
1500 Line Ave Ste 204
Shreveport, LA 71101-4648
Phone
(318) 300-4926
Fax
(318) 383-3951
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 025002 LA Primary

Addresses

Primary practice location

1500 Line Ave Ste 204
Shreveport, LA 71101-4648

Mailing address

PO Box 52364
Shreveport, LA 71135-2364
Phone (318) 798-4539

Other practice location 1

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 626-0000

Other identifiers 1

IdentifierTypeStateIssuer
1423611MedicaidLA

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
I20040720000879 LA Practitioner - Internal Medicine 9335129527 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1110 Keystone Cir
Bossier City, LA 71111-2178
Phone (318) 469-7315

1500 Line Ave
Shreveport, LA 71101-4639

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000

Hospital & facility affiliations

  • Elara Caring Home health agency, Bossier City, LA, CCN 197226
  • Centerwell Home Health Home health agency, Coushatta, LA, CCN 197334
  • Louisiana Homecare Home health agency, Mansfield, LA, CCN 197052
  • Specialists Hospital Shreveport Hospital, Shreveport, LA, CCN 190278
  • Ochsner Lsu Health Shreveport-St Mary Medical Cent Hospital, Shreveport, LA, CCN 190317
  • Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041
  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
  • Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
025002LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Internal Medicine CurrentSince Jun 6, 2022 Accepting new patients
C H Wilkinson Physician Network CurrentSince Feb 27, 2020 Accepting new patients
Sound Physicians Emergency Medicine of Louisiana Inc CurrentSince Sep 18, 2018 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
C H Wilkinson Physician Network Internal Medicine CurrentSince Feb 27, 2020 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Sep 18, 2018 Accepting new patients
Bossier Family Medicine, LLC CurrentSince Sep 11, 2022 Accepting new patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Dec 1, 2020 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients
Christus Health Northern Louisiana Past Accepting new patients

Locations

4481 Viking Dr
Bossier City, LA 71111
Phone (318) 626-2593

2351 Viking Dr
Bossier City, LA 71111
Phone (318) 681-4500

2539 Viking Dr
Ste 101
Bossier City, LA 71111
Phone (318) 747-8100

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

1460 E Bert Kouns Industrial Loop
Ste 700
Shreveport, LA 71105
Phone (318) 424-3291

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

6670 Saint Vincent Ave
Shreveport, LA 71106
Phone (318) 626-0500

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: joseph.tynes@bfm.eclinicaldirectplus.com

Organizations & group practices 11

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 11

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1306880778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52364",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711352364",
            "telephone_number": "318-798-4539",
            "fax_number": "318-798-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LINE AVE STE 204",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014648",
            "telephone_number": "318-300-4926",
            "fax_number": "318-383-3951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1541 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-626-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYNES",
        "first_name": "JOSEPH",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "025002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1423611",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.