Jessica Ann King, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AP08445 Issued in LA

Practice address

1811 E Bert Kouns Industrial Loop Ste 210
Shreveport, LA 71105-5740

Phone

(318) 212-3858

Fax

(318) 212-3958

NPI assigned

Aug 6, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jessica King Tidwell Former name

Medicare fee-for-service enrollment

Enrolled in LA, TX2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Pierremont CardiologyGroup PAC ID 0547571499, 27 clinicians

WKMC Cardiovascular ConsultantsGroup PAC ID 0941420061, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jtidwell134875@direct.tmfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• WKMC Cardiovascular Consultants

  • Cardiovascular Disease Physician
  • Shreveport, LA
  • NPI 1801205802
  Medicare reassignment Care Compare group NPD
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222
  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment NPD
• WK Pierremont Cardiology

  • Cardiovascular Disease Physician
  • Shreveport, LA
  • NPI 1235523002
  Care Compare group
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1629454160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP STE 210",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055740",
            "telephone_number": "318-212-3858",
            "fax_number": "318-212-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP STE 210",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055740",
            "telephone_number": "318-212-3858",
            "fax_number": "318-212-3958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 S Fleishel Ave",
            "address_2": "STE 5000",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012015",
            "country_code": "US",
            "telephone_number": "903-606-2830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "AP08445",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP130723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "TIDWELL",
            "middle_name": "KING",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• April King
• Ashley King, BCBA
• Barbara King, MS.,CCC-SLP
• Beatrice King
• Comeaka Shannon King
• John William King, M.D.
• Joyce A King, LCSW
• Natasha King
• Nietheia King
• Shykeria King

• Acute Care Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Acute Care Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.
• 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.