Individual provider Active NPI

Philip Donald Isherwood, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Shreveport, LA
National Provider Identifier
1497781611
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
13714R Issued in LA
Practice address
1501 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 675-5185
Fax
(318) 675-7950
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13714R LA
Addiction Medicine (Family Medicine) Physician 207QA0401X 13714R LA Primary

Addresses

Primary practice location

1501 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5185

Other identifiers 1

IdentifierTypeStateIssuer
1423131MedicaidLA

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
I20230731000895 LA Practitioner - Family Practice 6406744200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Applegate Health Services Inc 10 clinicians

Practice addresses (Care Compare)

1605 Benton Rd
Suite D
Bossier City, LA 71111-3579
Phone (318) 716-3814

3001 Armand St
Suite a
Monroe, LA 71201-3761
Phone (318) 582-2335

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Applegate Health Services, Inc. CurrentSince Sep 30, 2022 Accepting new patients
Baymark Health Services of Louisiana, Inc. CurrentSince Jan 13, 2017 Accepting new patients
Applegate Health Services, Inc CurrentSince Feb 24, 2023 Accepting new patients
Applegate Health Services, Inc. Past Accepting new patients
Applegate Health Services, Inc. Past Accepting new patients
Applegate Health Services, Inc Past Accepting new patients
Applegate Health Services, Inc Past Accepting new patients
Baymark Health Services of Louisiana, Inc. Past Accepting new patients
New Day Recovery, LLC Past Accepting new patients
Baymark Health Services of Louisiana, Inc. Past Accepting new patients
New Day Recovery, LLC Past Accepting new patients
Baymark Health Services of Louisiana, Inc. Past Accepting new patients

Locations

2116 N Bolton Ave
Alexandria, LA 71303
Phone (318) 441-0200

1605 Benton Rd
Ste D
Bossier City, LA 71111
Phone (318) 716-3814

648 Latiolais Dr
Breaux Bridge, LA 70517
Phone (337) 332-4878

615 Pride Dr
Hammond, LA 70401
Phone (985) 215-8978

128 Woodland Dr
La Place, LA 70068
Phone (985) 287-5572

3001 Armand St
Ste A
Monroe, LA 71201
Phone (318) 388-2203

700 Gause Blvd
Ste 103
Slidell, LA 70458
Phone (985) 643-3100

1720 Lakepointe Dr
Ste 117
Lewisville, TX 75057

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1497781611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5185",
            "fax_number": "318-675-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5185",
            "fax_number": "318-675-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHERWOOD",
        "first_name": "PHILIP",
        "middle_name": "DONALD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "13714R",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "LA",
            "license": "13714R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1423131",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.