NPIMap

Organization Active NPI

Novus Louisiana Medical Professional Corporation

  • Anesthesiology Physician
  • Shreveport, LA
National Provider Identifier
1336926872
Registry record updated Oct 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NOVUS LOUISIANA MEDICAL PROFESSIONAL CORPORATION
Practice address
1500 Line Ave Ste 206
Shreveport, LA 71101-4649
Phone
(318) 213-3800
NPI assigned
Sep 8, 2023
Last updated
Oct 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2026

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

Authorized official

Name
Mr. Joshua Poole
Title
President
Phone
(404) 285-8388

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

1500 Line Ave Ste 206
Shreveport, LA 71101-4649

Mailing address

PO Box 12766
Pensacola, FL 32591-2766
Phone (888) 228-5798

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/ Other Management Services Network, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231208002673 LA Part B Supplier - Clinic/Group Practice 5395194880 Receives reassigned benefits from 41 practitioners
Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792195200000",
    "number": "1336926872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12766",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325912766",
            "telephone_number": "888-228-5798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LINE AVE STE 206",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014649",
            "telephone_number": "318-213-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVUS LOUISIANA MEDICAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-08",
        "last_updated": "2026-10-17",
        "certification_date": "2026-10-17",
        "status": "A",
        "authorized_official_last_name": "POOLE",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-285-8388",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.1036.1",
            "affiliationName": "Management Services Network, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2357 Warm Springs Rd Ste 400",
            "city": "Columbus",
            "state": "GA",
            "country_code": "US",
            "postal_code": "319046874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.