Individual provider Active NPI

Arthur Mack Brister, MD

  • Emergency Medicine Physician
  • Shreveport, LA
National Provider Identifier
1700825221
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.023579 Issued in LA
Practice address
510 E Stoner Ave
Shreveport, LA 71101-4243
Phone
(318) 221-8411
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.023579 LA Primary

Addresses

Primary practice location

510 E Stoner Ave
Shreveport, LA 71101-4243

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other identifiers 1

IdentifierTypeStateIssuer
1486531MedicaidLA

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
I20090130000494 LA Practitioner - Emergency Medicine 9234293945 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.023579LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Louisiana Inc Emergency Medicine CurrentSince Feb 15, 2018 Accepting new patients
Highland Emergency Group, LLC Emergency Medicine CurrentSince Apr 20, 2021 Accepting new patients
Louisiana Em-1 Medical Services, PC Past Accepting new patients
Velocity MD LLC Past Accepting new patients
Velocity MD LLC Past Accepting new patients

Locations

2531 Viking Dr
Bossier City, LA 71111
Phone (318) 681-7000

200 Corporate Blvd
Lafayette, LA 70508

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1700825221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E STONER AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014243",
            "telephone_number": "318-221-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTER",
        "first_name": "ARTHUR",
        "middle_name": "MACK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.023579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1486531",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.