Individual provider Active NPI

Anne Z Boteler, NP

  • Acute Care Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1477287688
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
226732 Issued in LA
Practice address
8001 Youree Dr Ste 400
Shreveport, LA 71115-2340
Phone
(318) 212-3456
NPI assigned
Jul 13, 2022
Last updated
Sep 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 226732 LA Primary

Addresses

Primary practice location

8001 Youree Dr Ste 400
Shreveport, LA 71115-2340

Mailing address

8001 Youree Dr Ste 400
Shreveport, LA 71115-2340
Phone (318) 212-3456

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221024001707 LA Practitioner - Nurse Practitioner 1850767468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Moller Cassiere ClinicGroup PAC ID 3678587664, 10 clinicians
Cornerstone Therapy and Balance Center, LLCGroup PAC ID 0345397899, 98 clinicians

Practice addresses (Care Compare)

8001 Youree Dr
Suite 400
Shreveport, LA 71115-2340
Phone (318) 212-3456

8961 Youree Dr
Shreveport, LA 71115-3001
Phone (318) 671-8772

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
226732LAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WK Pierremont Hospitalists CurrentSince Jul 26, 2022 Accepting new patients
WK Moller Cassiere Clinic CurrentSince Sep 3, 2024 Accepting new patients

Locations

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

2510 Bert Kouns Industrial Loop
Shreveport, LA 71118
Phone (318) 212-5000

8001 Youree Dr
Ste 400
Shreveport, LA 71115
Phone (318) 212-3456

8001 Youree Dr
Ste 4007
Shreveport, LA 71115
Phone (318) 212-3821

8001 Youree Dr
Ste 880
Shreveport, LA 71115
Phone (318) 212-3908

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1477287688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR STE 400",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152340",
            "telephone_number": "318-212-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR STE 400",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152340",
            "telephone_number": "318-212-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTELER",
        "first_name": "ANNE",
        "middle_name": "Z",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "226732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.