Individual provider Active NPI

Karan Nichole Henry, PA-C

  • Physician Assistant
  • Shreveport, LA
National Provider Identifier
1700820412
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
A10582 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
Physician Assistant 363A00000X A10582 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
A10582LAMDPhysician Assistant

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": "1700820412",
    "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": "HENRY",
        "first_name": "KARAN",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "A10582",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.