WK Pierremont ENT

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

WK PIERREMONT ENT

Practice address

7847 Youree Dr
Shreveport, LA 71105-5505

Phone

(318) 212-3960

Fax

(318) 212-3907

NPI assigned

Jun 20, 2006

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) 212-3960

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Member of 1

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

• Willis Knighton Medical Center, Inc.

  • Skilled Nursing Facility
  • Shreveport, LA
  • NPI 1144267451

  Member Of

  NPD member

Locations

Practitioners 13

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

• Michael J. Beal, MD

  • Otolaryngology Physician
  • Shreveport, LA
  • NPI 1902834823
  Medicare reassignment Care Compare group NPD
• Joseph Houston Bosley, MD

  • Otolaryngology Physician
  • Shreveport, LA
  • NPI 1619960119
  Medicare reassignment Care Compare group NPD
• Jason Patrick Calligas, M.D.

  • Otolaryngology Physician
  • Shreveport, LA
  • NPI 1700102449
  Medicare reassignment Care Compare group NPD
• Shannon Colleen McCole, AUD

  • Audiologist
  • Shreveport, LA
  • NPI 1215663117
  Medicare reassignment Care Compare group NPD
• Mallory Leigh Stovall, AU.D.

  • Audiologist
  • Shreveport, LA
  • NPI 1518594035
  Medicare reassignment Care Compare group NPD
• Caroline Leigh Harris

  • Medical Physician Assistant
  • Shreveport, LA
  • NPI 1700496312
  Medicare reassignment Care Compare group
• John Eric Bicknell Sr., MD

  • Physical Medicine & Rehabilitation Physician
  • Shreveport, LA
  • NPI 1740357722
  NPD (past)
• Becky Carroll, FNP

  • Family Nurse Practitioner
  • Shreveport, LA
  • NPI 1235261710
  NPD (past)
• Diane Renee McCuller, NURSE PRACTITIONER

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1164649927
  NPD (past)
• Marsha Louise Murray, CFNP

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1437142247
  NPD (past)
• Clifford H Rice Jr., MD

  • Otolaryngology Physician
  • Shreveport, LA
  • NPI 1093719833
  NPD (past)
• Kristi Sue Cottrell, NURSE PRACTITIONER

  • Nurse Practitioner
  • Templeton, CA
  • NPI 1942224001
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358899200000",
    "number": "1659316727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7847 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055505",
            "telephone_number": "318-212-3960",
            "fax_number": "318-212-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7847 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055505",
            "telephone_number": "318-212-3960",
            "fax_number": "318-212-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK PIERREMONT ENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2013-01-23",
        "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": "318-212-3960"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034339",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WK Physicians Network
• WK Pierre Ave Community Health Education and Wellness Center
• WK Pierremont Associates in Internal Medicine
• WK Pierremont Cardiology
• WK Pierremont Endocrine Center
• WK Pierremont Eye Institute
• WK Pierremont Family Physicians
• WK Pierremont Hospitalists
• WK Pierremont Internal Medicine Associates
• WK Pierremont Neurology Clinic

• Otolaryngology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Otolaryngology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.