Individual provider Active NPI

Gentry Rinaudo Olden, NP

  • Family Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1689198988
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP09528 Issued in LA
Practice address
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 626-0000
NPI assigned
Jul 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP09528 LA Primary

Addresses

Primary practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1431 Dalzell St
Shreveport, LA 71103-3709
Phone (318) 626-0265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Health Shreveport LLC CurrentSince Oct 1, 2018 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Feb 10, 2020 Accepting new patients
Brfhh Monroe LLC Past Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAHBDD/Endpoint/GAHBDD

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1689198988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 DALZELL ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033709",
            "telephone_number": "318-626-0265",
            "fax_number": "318-629-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDEN",
        "first_name": "GENTRY",
        "middle_name": "RINAUDO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-28",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.