Individual provider Active NPI

Mindie Michelle Kavanaugh, MD

  • Hematology & Oncology Physician
  • Longview, TX
National Provider Identifier
1487897922
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
W6883 Issued in TX
Practice address
323 E Hawkins Pkwy Ste a-1
Longview, TX 75605-8153
Phone
(903) 544-6888
Fax
(903) 502-6089
NPI assigned
Apr 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 203912 LA
Internal Medicine Physician 207R00000X 203912 LA
Hematology & Oncology Physician 207RH0003X W6883 TX Primary

Addresses

Primary practice location

323 E Hawkins Pkwy Ste a-1
Longview, TX 75605-8153

Mailing address

1501 Kings Hwy
Department of Internal Medicine
Shreveport, LA 71103-4228
Phone (318) 675-5915

Other practice location 1

700 E Marshall Ave
Longview, TX 75601-5580
Phone (903) 315-2000

Other practice location 2

131 Spring Hill Rd
Longview, TX 75605-1147
Phone (903) 544-6888

Other practice location 3

1501 Kings Hwy
Department of Internal Medicine
Shreveport, LA 71103-4228
Phone (318) 813-1431

Other identifiers 2

IdentifierTypeStateIssuer
39108YH54OtherLAMEDICARE - PTAN
19933147MedicaidLA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150217000434 LA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 8123343050 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203912LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Internal Medicine CurrentSince Dec 1, 2016 Accepting new patients
Brfhh Monroe LLC Internal Medicine CurrentSince Nov 20, 2015 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1405 Kings Hwy
Shreveport, LA 71103
Phone (318) 813-1000

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

Interoperability endpoints

  • Direct secure messaging: mkavanaugh778334@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.

Hospital & facility affiliations 4

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": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1487897922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "address_2": "DEPARTMENT OF INTERNAL MEDICINE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5915",
            "fax_number": "318-675-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E HAWKINS PKWY STE A-1",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756058153",
            "telephone_number": "903-544-6888",
            "fax_number": "903-502-6089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015580",
            "country_code": "US",
            "telephone_number": "903-315-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "131 Spring Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756051147",
            "country_code": "US",
            "telephone_number": "903-544-6888",
            "fax_number": "903-502-6089",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 Kings Hwy",
            "address_2": "Department of Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-813-1431",
            "fax_number": "318-813-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "MINDIE",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "LA",
            "license": "203912",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "203912",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "W6883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - PTAN",
            "identifier": "39108YH54",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19933147",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.