NPIMap

Organization Active NPI

Louisiana State University Health Sciences Center

Doing business as Allied Health Clinics

  • Physical Therapist
  • Shreveport, LA
National Provider Identifier
1346609526
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Doing business as
Allied Health Clinics
Rehab Faculty Clinic
Practice address
1450 Claiborne Ave
Shreveport, LA 71103-4204
Phone
(318) 813-2970
Fax
(318) 813-2981
NPI assigned
Feb 17, 2016
Last updated
Jul 31, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Authorized official

Name
Reva Matthiew Robinson, MBA
Title
Director of Clin MGMT System
Phone
(318) 813-2962

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Student in an Organized Health Care Education/Training Program 390200000X NU
Physical Therapist 225100000X NU Primary
Neurology Physical Therapist 2251N0400X NU
Orthopedic Physical Therapist 2251X0800X NU
Physical Therapy Assistant 225200000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

1450 Claiborne Ave
Shreveport, LA 71103-4204

Mailing address

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 813-2970

Other identifiers 1

IdentifierTypeStateIssuer
1174173MedicaidLA

Other names 2

  • Allied Health Clinics Doing business as
  • Rehab Faculty Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Louisiana State University Health Sciences Center15 organizations share this tax ID, including this one
Part of
Louisiana State University Health Sciences Center

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596153600000",
    "number": "1346609526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-813-2970",
            "fax_number": "318-813-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CLAIBORNE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034204",
            "telephone_number": "318-813-2970",
            "fax_number": "318-813-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER",
        "enumeration_date": "2016-02-17",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "REVA",
        "authorized_official_middle_name": "MATTHIEW",
        "authorized_official_title_or_position": "DIRECTOR OF CLIN MGMT SYSTEM",
        "authorized_official_telephone_number": "318-813-2962",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174173",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allied Health Clinics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rehab Faculty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 31, 2020; 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.