Synergy International Healthcare Services, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SYNERGY INTERNATIONAL HEALTHCARE SERVICES, INC.

Practice address

5400 E Texas St
Bossier City, LA 71111-6906

Phone

(318) 675-1313

Fax

(318) 675-1319

NPI assigned

Dec 2, 2022

Organization subpart

No

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

Authorized official

Name

Cinder Irene Puckett

Title

President

Phone

(318) 464-7504

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 9

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

• Martha R Wafer, M.D.

  • Family Medicine Physician
  • Bossier City, LA
  • NPI 1619179421
  Medicare reassignment Care Compare group NPD
• Harlan Jay Weiss, M.D.

  • Internal Medicine Physician
  • Bossier City, LA
  • NPI 1932215456
  Medicare reassignment Care Compare group NPD
• Stefanie K Harden, PA

  • Physician Assistant
  • Bossier City, LA
  • NPI 1871948166
  Medicare reassignment Care Compare group
• Lauren Marie Wallace, PA-C

  • Physician Assistant
  • Bossier City, LA
  • NPI 1528926631
  Medicare reassignment Care Compare group
• Marjorie Blochousse, MD

  • Internal Medicine Physician
  • Bossier City, LA
  • NPI 1295626893
  Medicare reassignment NPD
• Janna S Nichols, NP

  • Nurse Practitioner
  • Bossier City, LA
  • NPI 1780918490
  Medicare reassignment NPD
• Kristy A Kehoe, PA

  • Physician Assistant
  • Bossier City, LA
  • NPI 1669796926
  Medicare reassignment
• Emma Grace Hixson Lieu, PA-C

  • Medical Physician Assistant
  • Dallas, TX
  • NPI 1710712625

  LA

  Medicare reassignment
• Annaliesa Fanguy, MD

  • Student in an Organized Health Care Education/Training Program
  • Mishawaka, IN
  • NPI 1760365530
  NPD

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1598475246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 E TEXAS ST",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711116906",
            "telephone_number": "318-675-1313",
            "fax_number": "318-675-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 E TEXAS ST",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711116906",
            "telephone_number": "318-675-1313",
            "fax_number": "318-675-1319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1860 Fairfield Ave",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711014431",
            "country_code": "US",
            "telephone_number": "318-675-1313",
            "fax_number": "318-675-1319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SYNERGY INTERNATIONAL HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-02",
        "last_updated": "2024-02-26",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "PUCKETT",
        "authorized_official_first_name": "CINDER",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-464-7504"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1823007",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3709163",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1059811",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3902940",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Sullivan
• Macey Sutherland, DO
• Cassandra Sweet-Johnson
• Nicole Sweet
• Ashley Swords, MCD-SLP/CCC
• Taaj, LLC
• Mary Kristine Tabangay, FNP
• Tammi Herkey WHNP and Willis-Knighton Medical Center
• Anthony Tanner, PA(ASCP)CM
• Brian Joseph Tassin, D.C.

• Primary Care Clinic/Center in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Primary Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.