Active NPI
Wanda H Thomas, M.D.
- Pediatrics Physician
- Shreveport, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 024938
- Practice address
- 1501 Kings Hwy
Department of Pediatrics
Shreveport, LA 71103-4228 - Phone
- (318) 675-8600
- Fax
- (318) 675-8638
- NPI assigned
- Jul 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 024938 | LA | Primary |
Addresses
Primary practice location
1501 Kings Hwy
Department of Pediatrics
Shreveport, LA 71103-4228
Mailing address
1512 W Kirby PL
Shreveport, LA 71103-3822
Phone (318) 675-8600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4E967F600 | Other | LA | MEDICARE - PTAN |
| 1423092 | Medicaid | LA |
Other names 1
- Wanda H Wells
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024938 | LA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lsu Health Sciences Center Shreveport Faculty Group Practice | Pediatrics | Current | Accepting new patients |
| Ochsner Lsu Health Shreveport - St. Mary Medical Center, LLC | Past | Accepting new patients | |
| Brfhh Shreveport LLC | Past | Accepting new patients |
Locations
4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000
1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402
1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177
1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287
1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434
Interoperability endpoints
- wthomas727963@direct.ochsner.org
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Shreveport, LA
- NPI 1013374222
Pediatrics
-
dba University Health Shreveport
- General Acute Care Hospital
- Shreveport, LA
- NPI 1912909912
-
dba Ochsner LSU Health Shreveport - St. Mary Medical Center
- Women's Hospital
- Shreveport, LA
- NPI 1285253252
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386633600000",
"number": "1457372237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1512 W KIRBY PL",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711033822",
"telephone_number": "318-675-8600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 KINGS HWY",
"address_2": "DEPARTMENT OF PEDIATRICS",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711034228",
"telephone_number": "318-675-8600",
"fax_number": "318-675-8638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "WANDA",
"middle_name": "H",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-21",
"last_updated": "2013-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "024938",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE - PTAN",
"identifier": "4E967F600",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1423092",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "WANDA",
"last_name": "WELLS",
"middle_name": "H",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
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 Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.