NPIMap

Organization Active NPI

Internal Medical Associates of Doctors Hospital

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1346208170
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTERNAL MEDICAL ASSOCIATES OF DOCTORS HOSPITAL
Practice address
128 Louisiana Ave
Shreveport, LA 71101-2754
Phone
(318) 425-3130
NPI assigned
May 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Leonard Keith Cox
Title
Authorized Representative
Phone
(318) 425-3130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X LA Primary

Addresses

Primary practice location

128 Louisiana Ave
Shreveport, LA 71101-2754

Mailing address

128 Louisiana Ave
Shreveport, LA 71101-2754

Other identifiers 1

IdentifierTypeStateIssuer
1114430MedicaidLA

National Provider Directory

National Provider Directory

Locations

1128 Louisiana Ave
Shreveport, LA 71101
Phone (318) 222-2273

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1346208170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711012754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711012754",
            "telephone_number": "318-425-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICAL ASSOCIATES OF DOCTORS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "318-425-3130"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114430",
            "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 21, 2022; 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.