Individual provider Active NPI

Cindy Lam

  • Family Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1538887609
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
226272 Issued in LA
Practice address
9460 Ellerbe Rd Ste 140
Shreveport, LA 71106-7468
Phone
(318) 213-7070
NPI assigned
Aug 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 226272 LA Primary

Addresses

Primary practice location

9460 Ellerbe Rd Ste 140
Shreveport, LA 71106-7468

Mailing address

7577 Old Mooringsport Rd
Shreveport, LA 71107-9255

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ezernack1@live.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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230621003167 LA Practitioner - Nurse Practitioner 3476911546 Reassigns benefits to 1 organization

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 Urgent Care Center-PierremontGroup PAC ID 8123016946, 39 clinicians

Practice addresses (Care Compare)

1666 E Bert Kouns Industrial Loop
Suite 105
Shreveport, LA 71105-5718
Phone (318) 212-3520

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226272LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WK Urgent Care Center-Pierremont CurrentSince Mar 28, 2023 Accepting new patients
WK Urgent Care Center - Bossier PastSince Jun 1, 2012 Accepting new patients
WK Advanced Surgery Center Past Accepting new patients

Locations

1001 Lackland Blvd
Ste 110
Benton, LA 71006
Phone (318) 935-1500

2300 Hospital Dr
Ste 180
Bossier City, LA 71111
Phone (318) 212-7520

5751 Shed Rd
Ste 100
Bossier City, LA 71111
Phone (318) 935-1900

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

9460 Ellerbe Rd
Ste 140
Shreveport, LA 71106
Phone (318) 213-7070

1666 E Bert Kouns Industrial Loop
Ste 105
Shreveport, LA 71105
Phone (318) 212-3520

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1538887609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7577 OLD MOORINGSPORT RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711079255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9460 ELLERBE RD STE 140",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067468",
            "telephone_number": "318-213-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "CINDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "226272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ezernack1@live.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7577 Old Mooringsport Rd",
            "city": "Shreveport",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711079255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.