Individual provider Active NPI

Chelsea Colvin Smith

  • Family Medicine Physician
  • Bossier City, LA
National Provider Identifier
1417443672
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AP.10117 Issued in LA
Practice address
2539 Viking Dr Ste 101
Bossier City, LA 71111-2165
Phone
(318) 747-8100
NPI assigned
Jul 10, 2018
Last updated
Oct 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AP.10117 LA Primary

Addresses

Primary practice location

2539 Viking Dr Ste 101
Bossier City, LA 71111-2165

Mailing address

2539 Viking Dr Ste 101
Bossier City, LA 71111-2165
Phone (318) 747-8100

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180829003814 LA Practitioner - Nurse Practitioner 3173873866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bossier Family Medicine, LLCGroup PAC ID 1850318122, 21 clinicians

Practice addresses (Care Compare)

2539 Viking Dr
Suite 101
Bossier City, LA 71111-2165
Phone (318) 747-8100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP.10117LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bossier Family Medicine, LLC Family Medicine CurrentSince Aug 1, 2018 Accepting new patients
Bossier Family Medicine, LLC CurrentSince Sep 11, 2022 Accepting new patients

Locations

2539 Viking Dr
Ste 100
Bossier City, LA 71111
Phone (318) 747-8100

2539 Viking Dr
Ste 101
Bossier City, LA 71111
Phone (318) 747-8100

5390 Barksdale Blvd
Ste 100
Bossier City, LA 71112
Phone (318) 747-8100

5390 Barksdale Blvd
Ste 200
Bossier City, LA 71112
Phone (318) 747-8100

160 Stone Creek Rd
Ste A
Stonewall, LA 71078
Phone (318) 925-3339

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGAJAA

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1417443672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 VIKING DR STE 101",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112165",
            "telephone_number": "318-747-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 VIKING DR STE 101",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112165",
            "telephone_number": "318-747-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHELSEA",
        "middle_name": "COLVIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "AP.10117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

Verify at the official NPI Registry.