WK Bossier Pediatric Partners

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

WK BOSSIER PEDIATRIC PARTNERS

Practice address

2300 Hospital Dr
Suite 120
Bossier City, LA 71111-2394

Phone

(318) 212-7883

Fax

(318) 212-7885

NPI assigned

Mar 30, 2010

Last updated

Jun 12, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Greg J Gavin

Title

Network Administrator

Phone

(318) 212-4232

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Practitioners 1

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.

• Quynh Tran Dang, MD

  • Pediatrics Physician
  • Bossier City, LA
  • NPI 1306882816
  NPD (past)

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1649595950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR",
            "address_2": "SUITE 120",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112394",
            "telephone_number": "318-212-7883",
            "fax_number": "318-212-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR",
            "address_2": "SUITE 120",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112394",
            "telephone_number": "318-212-7883",
            "fax_number": "318-212-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK BOSSIER PEDIATRIC PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-30",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NETWORK ADMINISTRATOR",
        "authorized_official_telephone_number": "318-212-4232"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2102583",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WK Bossier Hyperbaric and Wound Care Center
• WK Bossier Internal Medicine
• WK Bossier OB GYN Specialists
• WK Bossier OB-GYN
• WK Bossier Orthopedic & Sports
• WK Bossier Pulmonary & Critical Care Clinic
• WK Bossier River Cities Interventional Pain Specialists
• WK Bossier Surgical Associates
• WK Bossier Urology Clinic
• WK Center for Ear Nose and Throat Disorders

• Pediatrics Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.