Organization Active NPI

Grace Behavioral Health Solutions

  • Psychiatry Physician
  • Shreveport, LA
National Provider Identifier
1558662338
Registry record updated Sep 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD199987 Issued in LA
Legal business name
GRACE BEHAVIORAL HEALTH SOLUTIONS
Practice address
2924 Knight St
Suite 414
Shreveport, LA 71105-2415
Phone
(318) 861-7340
Fax
(318) 861-7390
NPI assigned
Nov 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2017

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

Authorized official

Name
Dr. Kimberly Dawn Law, M.D., M.P.H.NPI 1427029438
Title
Psychiatrist
Phone
(318) 453-4084

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X MD199987 LA Primary

Addresses

Primary practice location

2924 Knight St
Suite 414
Shreveport, LA 71105-2415

Mailing address

2924 Knight St
Suite 414
Shreveport, LA 71105-2415
Phone (318) 861-7340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110322000818 LA Part B Supplier - Clinic/Group Practice 2264615640 Receives reassigned benefits from 1 practitioner
Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory

Locations

2924 Knight St
#414
Shreveport, LA 71105

404 Hearne Ave
Shreveport, LA 71103
Phone (318) 716-1369

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504569600000",
    "number": "1558662338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 KNIGHT ST",
            "address_2": "SUITE 414",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052415",
            "telephone_number": "318-861-7340",
            "fax_number": "318-861-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 KNIGHT ST",
            "address_2": "SUITE 414",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052415",
            "telephone_number": "318-861-7340",
            "fax_number": "318-861-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE BEHAVIORAL HEALTH SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2017-09-05",
        "status": "A",
        "authorized_official_last_name": "LAW",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "318-453-4084",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., M.P.H."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "MD199987",
            "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 Sep 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.