Elizabeth Michelle Doolittle, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.200120 Issued in LA

Practice address

2449 Hospital Dr Ste 300
Bossier City, LA 71111

Phone

(318) 212-7960

Fax

(318) 212-7965

NPI assigned

May 1, 2007

Last updated

Dec 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Louisiana State University Health Sciences Center

  dba LSU Health Shreveport

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1417992249
  Medicare reassignment
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222
  Medicare reassignment
• WK Advanced Surgery Center

  • Surgery Physician
  • Shreveport, LA
  • NPI 1609110634
  Medicare reassignment
• WK Spine & Pain Specialists

  • Interventional Pain Medicine Physician
  • Bossier City, LA
  • NPI 1982065645
  Medicare reassignment
• WK Transplant Physicians

  • Transplant Surgery Physician
  • Shreveport, LA
  • NPI 1528307238
  Medicare reassignment
• WK River Cities Interventional Pain

  • Pain Medicine (Anesthesiology) Physician
  • Shreveport, LA
  • NPI 1962447052

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1609097070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-212-8951",
            "fax_number": "318-212-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2449 HOSPITAL DR STE 300",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "71111",
            "telephone_number": "318-212-7960",
            "fax_number": "318-212-7965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Line Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711014643",
            "country_code": "US",
            "telephone_number": "318-629-5555",
            "fax_number": "318-629-5556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOOLITTLE",
        "first_name": "ELIZABETH",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "PA.200120",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "LA",
            "license": "200120",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004383",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kailey Claire Mataconis Dodson, MSN, APRN, FNP-C
• Kate Doherty, P.T., D.P.T
• Timothy Joseph Doherty, RPH
• Katelyn Donaldson, MA, CCC-SLP
• Donna Ann Walker
• James R Dorman
• Daniel Alan Dorsey
• Latousha Dorsey
• Yolanda Dorsey
• Samantha Deeann Dortch

• Medical Physician Assistant in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Medical Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.