Powell Medical Center Minististries Inc

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

L012949 Issued in LA

Legal business name

POWELL MEDICAL CENTER MINISTISTRIES INC

Practice address

515 Pierre Ave
Shreveport, LA 71101-2445

Phone

(318) 221-4471

Fax

(318) 221-4913

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Albert H Powell, MD

Title

Physician

Phone

(318) 221-4471

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Karen M'Liss Pendleton, M.D.

  • Ophthalmology Physician
  • Shreveport, LA
  • NPI 1871781666
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437216710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PIERRE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711012445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 PIERRE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711012445",
            "telephone_number": "318-221-4471",
            "fax_number": "318-221-4913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL MEDICAL CENTER MINISTISTRIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "318-221-4471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "LA",
            "license": "L012949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1140376",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Yevette Pouncy
• Leo Pouncy
• Patricia Pouncy, B.S.
• Jeremiah M Pounds
• Tracy W. Pourciau, M.S., CCC-SLP
• Antoinette Stephens Powell
• Britney Jo Powell, NP
• Celeste Powell
• Deanna Lynn Powell, M.D.
• Kashanti Powell

• Point of Service in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Point of Service in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.