Individual provider Active NPI

Gordon M Mead, MD

  • Orthopaedic Surgery Physician
  • Shreveport, LA
National Provider Identifier
1518961317
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
012936 Issued in LA
Practice address
1455 E Bert Kouns Loop
Shreveport, LA 71105-5634
Phone
(318) 798-4623
Fax
(318) 798-4697
NPI assigned
Jun 9, 2005
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 012936 LA Primary

Addresses

Primary practice location

1455 E Bert Kouns Loop
Shreveport, LA 71105-5634

Mailing address

1455 E Bert Kouns Loop
Shreveport, LA 71105-5634
Phone (318) 798-4623

Other identifiers 4

IdentifierTypeStateIssuer
1140716MedicaidLA
1053315846OtherLAGROUP NPI NUMBER
200019864OtherLARAILROAD MEDICARE NUMBER
106519504OtherTXTEXAS MEDICAID NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gordon.mead.p1@direct.hcapmc.nextgenshare.com Direct

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
I20100106000830 LA Practitioner - Orthopedic Surgery 0648371559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Emory University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Clinic, a Prof Med CorpGroup PAC ID 3870493463, 60 clinicians

Practice addresses (Care Compare)

1455 E Bert Koun Loop
Shreveport, LA 71105-5634
Phone (318) 798-4539

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012936LAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Orthopaedic Surgery CurrentSince Dec 1, 2016 Accepting new patients
Highland Clinic, a Prof Med Corp CurrentSince Jul 1, 1966 Accepting new patients
Highland Clinic, a Prof Med Corp Orthopaedic Surgery CurrentSince Jul 1, 1966 Accepting new patients
Highland Clinic, a Prof Med Corp Past Accepting new patients
Highland Clinic, a Prof Med Corp Orthopaedic Surgery Past Accepting new patients

Locations

1455 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 300-3643

1455 E Bert Kouns Industrial Loop
Ste 201
Shreveport, LA 71105

1455 E Bert Kouns Industrial Loop
Ste 210
Shreveport, LA 71105
Phone (318) 798-4623

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

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

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

7925 Youree Dr
Ste 220
Shreveport, LA 71105
Phone (318) 424-3400

Organizations & group practices 5

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 1

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1518961317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 E BERT KOUNS LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055634",
            "telephone_number": "318-798-4623",
            "fax_number": "318-798-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E BERT KOUNS LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055634",
            "telephone_number": "318-798-4623",
            "fax_number": "318-798-4697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEAD",
        "first_name": "GORDON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "012936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1140716",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1053315846",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "200019864",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAID NUMBER",
            "identifier": "106519504",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gordon.mead.p1@direct.hcapmc.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1455 E Bert Kouns Loop",
            "city": "Shreveport",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711055634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.