Organization Active NPI

Louisiana Neurologic Specialties Inc

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Shreveport, LA
National Provider Identifier
1417098385
Registry record updated Aug 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
09699R Issued in LA
Legal business name
LOUISIANA NEUROLOGIC SPECIALTIES INC
Practice address
7929 Youree Dr
Shreveport, LA 71105-5538
Phone
(318) 424-3268
Fax
(318) 424-3280
NPI assigned
Feb 12, 2007
Last updated
Aug 24, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2007

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

Authorized official

Name
Dr. Benjamin Bang V. Nguyen, M.D.
Title
Owner
Phone
(318) 424-3268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 09699R LA Primary

Addresses

Primary practice location

7929 Youree Dr
Shreveport, LA 71105-5538

Mailing address

7929 Youree Dr
Shreveport, LA 71105-5538
Phone (318) 424-3268

Other identifiers 1

IdentifierTypeStateIssuer
1981087MedicaidLA

National Provider Directory

National Provider Directory

Locations

7929 Youree Dr
Shreveport, LA 71105
Phone (318) 212-3817

Practitioners & affiliated clinicians

Practitioners 1

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": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187913600000",
    "number": "1417098385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7929 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055538",
            "telephone_number": "318-424-3268",
            "fax_number": "318-424-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7929 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055538",
            "telephone_number": "318-424-3268",
            "fax_number": "318-424-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA NEUROLOGIC SPECIALTIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-08-24",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "BANG V.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-424-3268",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "LA",
            "license": "09699R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1981087",
            "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 Aug 24, 2007; 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.