Organization Active NPI

Robert Hernandez MD and Willis-Knighton Medical Center

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1528094679
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ROBERT HERNANDEZ MD AND WILLIS-KNIGHTON MEDICAL CENTER
Practice address
8001 Youree Dr
Suite 450
Shreveport, LA 71115-2302
Phone
(318) 212-3952
Fax
(318) 212-3955
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Greg J Gavin
Title
Network Administrator
Phone
(318) 212-3952

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

8001 Youree Dr
Suite 450
Shreveport, LA 71115-2302

Mailing address

8001 Youree Dr
Suite 450
Shreveport, LA 71115-2302
Phone (318) 212-3952

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528094679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "address_2": "SUITE 450",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-212-3952",
            "fax_number": "318-212-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "address_2": "SUITE 450",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-212-3952",
            "fax_number": "318-212-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT HERNANDEZ MD AND WILLIS-KNIGHTON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NETWORK ADMINISTRATOR",
        "authorized_official_telephone_number": "318-212-3952"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.