WK Pierremont Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

WK PIERREMONT PEDIATRICS

Practice address

1811 E Bert Kouns Industrial Loop
Suite 140
Shreveport, LA 71105-5563

Phone

(318) 797-9000

Fax

(318) 797-9275

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Greg J. Gavin

Title

Network Administrator

Phone

(318) 212-4232

Specialties & licenses 1

Addresses

Other identifiers 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

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Abbey M. Carroll, MD

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1346459195
  NPD (past)
• Margaret Crittell, MD

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1235175696
  NPD (past)
• Emily R Hobson, M.D.

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1578562567
  NPD (past)
• Donald Gene Mack Jr., MD

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1154498491
  NPD (past)
• Tamara Lynn Moore, M.D.

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1497011001
  NPD (past)
• Mackey Sugar Quinlan

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1831300136
  NPD (past)

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1376745794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "SUITE 140",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055563",
            "telephone_number": "318-797-9000",
            "fax_number": "318-797-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "SUITE 140",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055563",
            "telephone_number": "318-797-9000",
            "fax_number": "318-797-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK PIERREMONT PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2012-06-12",
        "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": "318-212-4232"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1448907",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WK Pierremont Family Physicians
• WK Pierremont Hospitalists
• WK Pierremont Internal Medicine Associates
• WK Pierremont Neurology Clinic
• WK Pierremont OB-GYN Specialists
• WK Pierremont Psychiatry
• WK Pierremont Womens Clinic
• WK Pines Road Family Medicine
• WK Pinnacle Gastroenterology
• WK Portico Pediatrics

• Pediatrics Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.