NPIMap

Organization Active NPI

WK Urgent Care Center-Pierremont

  • Family Medicine Physician
  • Shreveport, LA
National Provider Identifier
1639115132
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WK URGENT CARE CENTER-PIERREMONT
Practice address
1666 E Bert Kouns Loop
Suite 105
Shreveport, LA 71105-5714
Phone
(318) 212-3520
Fax
(318) 212-3525
NPI assigned
Jun 22, 2006
Last updated
Oct 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Authorized official

Name
Steven Randall
Title
VP Administration
Phone
(318) 212-3520

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X
Occupational Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2083X0100X

Addresses

Primary practice location

1666 E Bert Kouns Loop
Suite 105
Shreveport, LA 71105-5714

Mailing address

1666 E Bert Kouns Loop
Suite 105
Shreveport, LA 71105-5714
Phone (318) 212-3520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040503000206 LA Part B Supplier - Clinic/Group Practice 8123016946 Receives reassigned benefits from 58 practitioners
Practice locations: Shreveport, LA; Bossier City, LA; Benton, LA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D0963125WK Urgent Care Pierremont1666 East Bert Kouns, Suite 105, Shreveport, LA 71105Certificate of waiverNov 21, 2026

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1001 Lackland Blvd
Ste 110
Benton, LA 71006
Phone (318) 935-1500

2300 Hospital Dr
Ste 180
Bossier City, LA 71111
Phone (318) 212-7520

1666 E Bert Kouns Industrial Loop
Ste 105
Shreveport, LA 71105
Phone (318) 212-3520

2520 Bert Kouns Ind Loop
Ste 105A
Shreveport, LA 71118
Phone (318) 688-0173

2520 Bert Kouns Industrial Loop
Shreveport, LA 71118

5621 N Market St
Ste 100
Shreveport, LA 71107
Phone (318) 935-1700

9460 Ellerbe Rd
Shreveport, LA 71106

9460 Ellerbe Rd
Ste 140
Shreveport, LA 71106
Phone (318) 213-7070

Practitioners & affiliated clinicians

Practitioners 62

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1639115132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 E BERT KOUNS LOOP",
            "address_2": "SUITE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055714",
            "telephone_number": "318-212-3520",
            "fax_number": "318-212-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 E BERT KOUNS LOOP",
            "address_2": "SUITE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055714",
            "telephone_number": "318-212-3520",
            "fax_number": "318-212-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK URGENT CARE CENTER-PIERREMONT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "VP ADMINISTRATION",
        "authorized_official_telephone_number": "318-212-3520"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.