Individual provider Active NPI

Hester Suh, M.D.

  • Pediatrics Physician
  • Shreveport, LA
National Provider Identifier
1407042435
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD.204975 Issued in LA
Practice address
2709 Mackey LN
Shreveport, LA 71118-2556
Phone
(318) 505-7626
Fax
(877) 571-9488
NPI assigned
Sep 24, 2007
Last updated
Mar 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01063660A IN
Pediatrics Physician 208000000X MD.204975 LA Primary

Addresses

Primary practice location

2709 Mackey LN
Shreveport, LA 71118-2556

Mailing address

2709 Mackey LN
Shreveport, LA 71118-2556
Phone (318) 505-7626

Other identifiers 2

IdentifierTypeStateIssuer
200891400MedicaidIN
2175581MedicaidLA

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
I20170915000189 LA Practitioner - Pediatric Medicine 8820167703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
State University of New York at Stony Brook, School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2709 Mackey LN
Shreveport, LA 71118-2556
Phone (318) 505-7626

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01063660AINMDPediatrics Physician
MD.204975LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wee Care Pediatrics, LLC Pediatrics CurrentSince Aug 1, 2017 Accepting new patients
Marion Pediatrics LLC Past Accepting new patients
Willis Knighton Medical Center, Inc. Past Accepting new patients

Locations

2709 Mackey Ln
Shreveport, LA 71118
Phone (318) 505-7626

Organizations & group practices 3

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": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1407042435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 MACKEY LN",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182556",
            "telephone_number": "318-505-7626",
            "fax_number": "877-571-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 MACKEY LN",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182556",
            "telephone_number": "318-505-7626",
            "fax_number": "877-571-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUH",
        "first_name": "HESTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01063660A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.204975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200891400",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2175581",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.