WK Pinnacle Gastroenterology

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

WK PINNACLE GASTROENTEROLOGY

Practice address

2551 Greenwood Rd
Suite 350
Shreveport, LA 71103-3981

Phone

(318) 212-8710

Fax

(318) 212-8699

NPI assigned

Nov 28, 2005

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) 212-4571

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.

  dba WK Extended Care Center

  • Skilled Nursing Facility
  • Shreveport, LA
  • NPI 1144267451

  Member Of

  NPD member

Locations

Practitioners 5

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

• Krista Jarrett

  • Family Nurse Practitioner
  • Shreveport, LA
  • NPI 1184504342
  Medicare reassignment Care Compare group NPD
• Thomas Ryan Palmer, M.D.

  • Gastroenterology Physician
  • Bossier City, LA
  • NPI 1578619912
  Medicare reassignment Care Compare group NPD
• Sherif Michael

  • Gastroenterology Physician
  • Santa Barbara, CA
  • NPI 1699185884

  LA, Single Specialty

  Medicare reassignment Care Compare group NPD
• Megan O'Dell Johnson

  • Physician Assistant
  • Shreveport, LA
  • NPI 1902051386
  Medicare reassignment Care Compare group
• Patricia Lynne Strickland, NP

  • Family Nurse Practitioner
  • Shreveport, LA
  • NPI 1851898621
  Medicare reassignment NPD

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1669455226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD RD",
            "address_2": "SUITE 350",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033981",
            "telephone_number": "318-212-8710",
            "fax_number": "318-212-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD RD",
            "address_2": "SUITE 350",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033981",
            "telephone_number": "318-212-8710",
            "fax_number": "318-212-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK PINNACLE GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2012-06-08",
        "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": "318-212-4571"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1448834",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WK Pierremont OB-GYN Specialists
• WK Pierremont Pediatrics
• WK Pierremont Psychiatry
• WK Pierremont Womens Clinic
• WK Pines Road Family Medicine
• WK Portico Pediatrics
• WK Psychology Specialty Center
• WK Radiation Oncology Services
• WK Red River Cardiovascular Surgeons
• WK Regional Perinatal Group

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.