NPIMap

Organization Active NPI

Medical Center Anesthesiologists

  • Anesthesiology Physician
  • Shreveport, LA
National Provider Identifier
1669469748
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MEDICAL CENTER ANESTHESIOLOGISTS
Practice address
1 Saint Mary PL
Anesthesia Dept
Shreveport, LA 71101-4343
Phone
(318) 681-4440
Fax
(318) 681-6862
NPI assigned
Oct 4, 2005
Last updated
Jan 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Authorized official

Name
Dr. David Collins Deas, MDNPI 1942297031
Title
Chief of Anesthesia- President
Phone
(318) 681-4440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

1 Saint Mary PL
Anesthesia Dept
Shreveport, LA 71101-4343

Mailing address

1343 Canton Rd Ste C
Marietta, GA 30066-6079
Phone (318) 300-3643

Other identifiers 2

IdentifierTypeStateIssuer
C50853OtherLAMCR RAILROAD
1795241MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050419001114 LA Part B Supplier - Clinic/Group Practice 6608814843 Receives reassigned benefits from 78 practitioners
Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory

Locations

3010 Knight St
Ste 130
Shreveport, LA 71105

Practitioners & affiliated clinicians

Practitioners 80

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 80

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1669469748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1343 CANTON RD STE C",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666079",
            "telephone_number": "318-300-3643",
            "fax_number": "678-888-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT MARY PL",
            "address_2": "ANESTHESIA DEPT",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014343",
            "telephone_number": "318-681-4440",
            "fax_number": "318-681-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER ANESTHESIOLOGISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "DEAS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "COLLINS",
        "authorized_official_title_or_position": "CHIEF OF ANESTHESIA- PRESIDENT",
        "authorized_official_telephone_number": "318-681-4440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR RAILROAD",
            "identifier": "C50853",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1795241",
            "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 Jan 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.