Individual provider Active NPI

Andrew W Larson, MD

  • Anesthesiology Physician
  • Shreveport, LA
National Provider Identifier
1386810430
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD.205360 Issued in LA
Practice address
1 Saint Mary PL
Shreveport, LA 71101-4343
Phone
(337) 781-9522
NPI assigned
May 7, 2008
Last updated
Jun 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD.205360 LA Primary

Addresses

Primary practice location

1 Saint Mary PL
Shreveport, LA 71101-4343

Mailing address

1 Saint Mary PL
Shreveport, LA 71101-4343
Phone (337) 781-9522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120709000743 LA Practitioner - Anesthesiology 7113182544 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Anesthesiology CurrentSince Mar 1, 2019 Accepting new patients
Osc Anesthesia, LLC Anesthesiology CurrentSince Jul 18, 2024 Accepting new patients
Christus Surgery Center Villages LLC Current Accepting new patients

Locations

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

385 Bert Kouns Loop
Ste 300
Shreveport, LA 71106
Phone (318) 212-0552

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

255 Bert Kouns Loop
Shreveport, LA 71106
Phone (318) 682-4590

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1386810430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAINT MARY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014343",
            "telephone_number": "337-781-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT MARY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014343",
            "telephone_number": "337-781-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "ANDREW",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "MD.205360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.