Organization Active NPI

Biomedical Research Foundation of Northwest Louisiana

  • Radiology Clinic/Center
  • Shreveport, LA
National Provider Identifier
1437241130
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
BIOMEDICAL RESEARCH FOUNDATION OF NORTHWEST LOUISIANA
Practice address
2120 Kings Hwy
Shreveport, LA 71103-4015
Phone
(318) 716-4000
Fax
(318) 716-4075
NPI assigned
Sep 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Authorized official

Name
Mr. James D Dean
Title
Executive Vice President/Coo
Phone
(318) 716-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

2120 Kings Hwy
Shreveport, LA 71103-4015

Mailing address

PO Box 38050
Shreveport, LA 71133-8050
Phone (318) 716-4000

Other identifiers 1

IdentifierTypeStateIssuer
1948888MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060112000197 LA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4082637301 Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory

Member organizations 6

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650931200000",
    "number": "1437241130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38050",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711338050",
            "telephone_number": "318-716-4000",
            "fax_number": "318-716-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034015",
            "telephone_number": "318-716-4000",
            "fax_number": "318-716-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOMEDICAL RESEARCH FOUNDATION OF NORTHWEST LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT/COO",
        "authorized_official_telephone_number": "318-716-4100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1948888",
            "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 Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.