Active NPI
Henry Edward Wood Jr., MD
- Nephrology Physician
- Shreveport, LA
National Provider Identifier
1447242680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 15619
- Practice address
- 745 Olive St
Ste 200
Shreveport, LA 71104-2246 - Phone
- (318) 226-0809
- Fax
- (318) 226-0812
- NPI assigned
- Aug 15, 2005
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 15619 | LA | Primary |
| Nephrology Physician | 207RN0300X | 9905 | MS |
Addresses
Primary practice location
745 Olive St
Ste 200
Shreveport, LA 71104-2246
Mailing address
745 Olive St
Ste 200
Shreveport, LA 71104-2246
Phone (318) 226-0809
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1949442 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15619 | LA | MD | Nephrology Physician |
| 9905 | MS | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nephrology Consultants LLC | Nephrology | Past | Accepting new patients |
| Delta Nephrology LLC | Nephrology | Past | Accepting new patients |
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.
-
- Nephrology Physician
- Shreveport, LA
- NPI 1356713440
-
- Nephrology Physician
- Shreveport, LA
- NPI 1265541312
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447242680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "745 OLIVE ST",
"address_2": "STE 200",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711042246",
"telephone_number": "318-226-0809",
"fax_number": "318-226-0812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "745 OLIVE ST",
"address_2": "STE 200",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711042246",
"telephone_number": "318-226-0809",
"fax_number": "318-226-0812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "HENRY",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "LA",
"license": "15619",
"primary": true
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MS",
"license": "9905",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1949442",
"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 Jul 8, 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.