Individual provider Active NPI

Robert Bruce Williams, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Shreveport, LA
National Provider Identifier
1457349946
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
03815R Issued in LA
Practice address
2915 Missouri Ave
Shreveport, LA 71109-4327
Phone
(318) 364-2000
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 03815R LA Primary

Addresses

Primary practice location

2915 Missouri Ave
Shreveport, LA 71109-4327

Mailing address

PO Box 9600
Dept. 09-021
Texarkana, TX 75505-9600
Phone (318) 868-0932

Other identifiers 1

IdentifierTypeStateIssuer
1397792MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100416000238 LA Practitioner - Pathology 8628011996 Reassigns benefits to 1 organization
I20251224001633 AR Practitioner - Pathology 8628011996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Delta Pathology Group LLCGroup PAC ID 4789639089, 28 clinicians

Practice addresses (Care Compare)

2915 Missouri Ave
Shreveport, LA 71109-4327
Phone (318) 364-2000

309 Jackson St
Monroe, LA 71201-7407
Phone (318) 966-4886

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-4640

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
03815RLAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Delta Pathology Group LLC Anatomic Pathology & Clinical Pathology CurrentSince Sep 26, 2025 Accepting new patients
Pathology Associates of Mid Louisiana Anatomic Pathology & Clinical Pathology Past Accepting new patients
The Delta Pathology Group, L.L.C. Past Accepting new patients

Locations

130 Medical Cir
Nashville, AR 71852
Phone (501) 624-7700

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

309 Jackson St
Monroe, LA 71201
Phone (318) 966-4000

2915 Missouri Ave
Shreveport, LA 71109
Phone (318) 364-2000

3290 Knight St
Shreveport, LA 71105
Phone (318) 621-8820

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1457349946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9600",
            "address_2": "DEPT. 09-021",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755059600",
            "telephone_number": "318-868-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 MISSOURI AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711094327",
            "telephone_number": "318-364-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROBERT",
        "middle_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "LA",
            "license": "03815R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1397792",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.