Organization Active NPI

Dharam P Gurwara Apmc

  • Neurology Physician
  • Shreveport, LA
National Provider Identifier
1639331283
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
017034 Issued in LA
Legal business name
DHARAM P GURWARA APMC
Practice address
6047 Five Oaks Dr
Suite D
Shreveport, LA 71129-2596
Phone
(318) 752-2890
Fax
(318) 752-2890
NPI assigned
Jun 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Authorized official

Name
Dharam Prakash Gurwara, M.DNPI 1689783342
Title
MD Owner
Phone
(318) 752-2890

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 017034 LA
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X 017034 LA Primary

Addresses

Primary practice location

6047 Five Oaks Dr
Suite D
Shreveport, LA 71129-2596

Mailing address

PO Box 5027
Bossier City, LA 71171-5027
Phone (318) 752-2890

Other identifiers 1

IdentifierTypeStateIssuer
1900885MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080815000462 LA Part B Supplier - Clinic/Group Practice 4385719962 Receives reassigned benefits from 1 practitioner
Practice locations: Natchitoches, LA; Shreveport, LA; Bossier City, LA; Mansfield, LA

National Provider Directory

National Provider Directory

Locations

501 Keyser Ave
Fl 4
Natchitoches, LA 71457
Phone (318) 214-4200

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1639331283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5027",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711715027",
            "telephone_number": "318-752-2890",
            "fax_number": "318-752-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6047 FIVE OAKS DR",
            "address_2": "SUITE D",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711292596",
            "telephone_number": "318-752-2890",
            "fax_number": "318-752-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHARAM P GURWARA APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "GURWARA",
        "authorized_official_first_name": "DHARAM",
        "authorized_official_middle_name": "PRAKASH",
        "authorized_official_title_or_position": "MD OWNER",
        "authorized_official_telephone_number": "318-752-2890",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "LA",
            "license": "017034",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "017034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1900885",
            "state": "LA"
        }
    ],
    "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 Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.