Individual provider Active NPI

Tiffany Alexis Najberg, D.O.

  • Emergency Medicine Physician
  • Shreveport, LA
National Provider Identifier
1609069103
Registry record updated Jan 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO.000009 Issued in LA
Practice address
201 Market St
Shreveport, LA 71101-2830
Phone
(318) 801-4120
NPI assigned
Aug 20, 2007
Last updated
Jan 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X DO.000009 LA
Emergency Medicine Physician 207P00000X DO.000009 LA Primary

Addresses

Primary practice location

201 Market St
Shreveport, LA 71101-2830

Mailing address

201 Market St
Shreveport, LA 71101-2830
Phone (318) 299-6512

Other identifiers 2

IdentifierTypeStateIssuer
1064203MedicaidLA
02408202MedicaidMS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070910000919 LA Practitioner - Osteopathic Manipulative MedicinePractitioner - Emergency Medicine 0547353310 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Dec 1, 2020 Accepting new patients
South Central Physicians PLLC CurrentSince Dec 1, 2020 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Dec 1, 2020 Accepting new patients
Concord North Texas, PLLC Emergency Medicine CurrentSince Nov 15, 2020 Accepting new patients

Locations

323 W Walnut Ave
Bastrop, LA 71220
Phone (318) 283-3600

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

165 Beech Springs Rd
Jonesboro, LA 71251
Phone (318) 259-4435

Interoperability endpoints

  • Direct secure messaging: christopher.najberg@217526021193732.direct.elationemr.com

Organizations & group practices 4

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": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673740800000",
    "number": "1609069103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MARKET ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711012830",
            "telephone_number": "318-299-6512",
            "fax_number": "318-299-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MARKET ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711012830",
            "telephone_number": "318-801-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAJBERG",
        "first_name": "TIFFANY",
        "middle_name": "ALEXIS",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2023-01-15",
        "certification_date": "2023-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "LA",
            "license": "DO.000009",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "DO.000009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1064203",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02408202",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.