WK Bossier OB-GYN

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

WK BOSSIER OB-GYN

Practice address

2449 Hospital Dr
Suite 260
Bossier City, LA 71111-2399

Phone

(318) 212-7840

Fax

(318) 212-7845

NPI assigned

Jun 11, 2006

Last updated

Jun 8, 2012By 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

Mr. Greg J. Gavin

Title

Network Administrator

Phone

(318) 212-8780

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

Locations

Practitioners 10

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.

• Leonard Gregory Blanton, MD

  • Obstetrics & Gynecology Physician
  • Bossier City, LA
  • NPI 1831135698
  Medicare reassignment Care Compare group NPD
• Thresa Caughman, WHNP-BC

  • Women's Health Nurse Practitioner
  • Bossier City, LA
  • NPI 1255826897
  Medicare reassignment Care Compare group NPD
• Jennifer Allen Long, R.N.C.,W.H.N.P.

  • Obstetrics & Gynecology Nurse Practitioner
  • Bossier City, LA
  • NPI 1164515169
  Medicare reassignment Care Compare group NPD
• Leslie Stovall

  • Obstetrics & Gynecology Nurse Practitioner
  • Bossier City, LA
  • NPI 1841615127
  Medicare reassignment Care Compare group NPD
• Amanda Williams, M.D.

  • Obstetrics & Gynecology Physician
  • Bossier City, LA
  • NPI 1629289657
  Medicare reassignment Care Compare group NPD
• Kristen G. Robinson, PA

  • Physician Assistant
  • Bossier City, LA
  • NPI 1811207343
  Medicare reassignment Care Compare group
• Claire McMillan Bellew

  • Women's Health Nurse Practitioner
  • Bossier City, LA
  • NPI 1245187137
  Medicare reassignment NPD
• Lauren Gernand Banet, PA-C

  • Physician Assistant
  • Bossier City, LA
  • NPI 1922348887
  Medicare reassignment
• Russell D Burlison, MD

  • Obstetrics & Gynecology Physician
  • Shreveport, LA
  • NPI 1073517975
  NPD (past)
• Gary Menefee, M.D.

  • Obstetrics & Gynecology Physician
  • Monroe, LA
  • NPI 1679585947
  NPD (past)

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1326080995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2449 HOSPITAL DR",
            "address_2": "SUITE 260",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112399",
            "telephone_number": "318-212-7840",
            "fax_number": "318-212-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2449 HOSPITAL DR",
            "address_2": "SUITE 260",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112399",
            "telephone_number": "318-212-7840",
            "fax_number": "318-212-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK BOSSIER OB-GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2012-06-08",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452874",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WK Bossier ENT & Allergy Institute
• WK Bossier Hospitalists
• WK Bossier Hyperbaric and Wound Care Center
• WK Bossier Internal Medicine
• WK Bossier OB GYN Specialists
• WK Bossier Orthopedic & Sports
• WK Bossier Pediatric Partners
• WK Bossier Pulmonary & Critical Care Clinic
• WK Bossier River Cities Interventional Pain Specialists
• WK Bossier Surgical Associates

• Obstetrics & Gynecology Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Obstetrics & Gynecology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.