Individual provider Active NPI

Laura Sherrod Haynie, M.D.

  • Dermatology Physician
  • Shreveport, LA
National Provider Identifier
1679517148
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
017142 Issued in LA
Practice address
2751 Albert L Bicknell Dr
Suite 2-D
Shreveport, LA 71103-3920
Phone
(318) 221-2623
Fax
(318) 424-9850
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 017142 LA Primary

Addresses

Primary practice location

2751 Albert L Bicknell Dr
Suite 2-D
Shreveport, LA 71103-3920

Mailing address

2751 Albert L Bicknell Dr
Suite 2-D
Shreveport, LA 71103-3920
Phone (318) 221-2623

Other identifiers 1

IdentifierTypeStateIssuer
1374318MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080111000074 LA Practitioner - Dermatology 5193806503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in Shreveport, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology and Skin Surgery ApmcGroup PAC ID 5294627683, 9 clinicians

Practice addresses (Care Compare)

9007 Ellerbe Rd
Shreveport, LA 71106-6724
Phone (318) 222-3278

Hospital & facility affiliations

  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision27
Removal of skin lesions1950
Removal or shaving of skin growth257
Skin biopsy193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
017142LAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology and Skin Surgery Apmc Dermatology CurrentSince Dec 16, 2007 Accepting new patients
J. Woodson Dermatology & Associates Dermatology PastSince Dec 1, 2012 Accepting new patients
James R Bergeron M D a Med Corp Past Accepting new patients

Locations

9007 Ellerbe Rd
Shreveport, LA 71106
Phone (318) 222-3278

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1679517148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR",
            "address_2": "SUITE 2-D",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033920",
            "telephone_number": "318-221-2623",
            "fax_number": "318-424-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR",
            "address_2": "SUITE 2-D",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033920",
            "telephone_number": "318-221-2623",
            "fax_number": "318-424-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNIE",
        "first_name": "LAURA",
        "middle_name": "SHERROD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "017142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1374318",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.