WK Vascular Surgical Associates

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

WK VASCULAR SURGICAL ASSOCIATES

Practice address

2751 Albert L Bicknell Dr
Suite 5a
Shreveport, LA 71103-3920

Phone

(318) 226-0058

Fax

(318) 226-1759

NPI assigned

Jan 20, 2010

Organization subpart

No

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) 212-4232

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Member of 1

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

• Willis Knighton Medical Center, Inc.

  • Skilled Nursing Facility
  • Shreveport, LA
  • NPI 1144267451

  Member Of

  NPD member

Practitioners 2

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

• Fredrick Willius Knight, M.D.

  • Vascular Surgery Physician
  • Shreveport, LA
  • NPI 1538209697
  Medicare reassignment
• Forrest Holt Wright, M.D.

  • Surgery Physician
  • Shreveport, LA
  • NPI 1770675282
  NPD

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1598096240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR",
            "address_2": "SUITE 5A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033920",
            "telephone_number": "318-226-0058",
            "fax_number": "318-226-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR",
            "address_2": "SUITE 5A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033920",
            "telephone_number": "318-226-0058",
            "fax_number": "318-226-1759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK VASCULAR SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2012-06-08",
        "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": "318-212-4232"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WK Urologic Cancer Care
• WK Urologic Oncology Pierremont
• WK Urology
• WK Urology at Pierremont
• WK Vascular Surgery
• WK Vein Specialists
• WK Womens Health Clinic
• WK Womens Specialists at South
• WKH Physical Medicine Physicians
• WKMC Cardiovascular Consultants

• Vascular Surgery Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Vascular Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.