NPIMap

Organization Active NPI

Northwest la Incs, LLC

  • Point of Service
  • Shreveport, LA
National Provider Identifier
1700901683
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
11761 Issued in LA
Legal business name
NORTHWEST LA INCS, LLC
Practice address
4111 Metro Dr
Shreveport, LA 71109-6001
Phone
(318) 636-0390
Fax
(318) 635-3298
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Cindy S Parker, R.N.
Title
Regional Coordinator
Phone
(318) 636-0390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 11761 LA Primary

Addresses

Primary practice location

4111 Metro Dr
Shreveport, LA 71109-6001

Mailing address

4111 Metro Dr
Shreveport, LA 71109-6001
Phone (318) 636-0390

Other identifiers 1

IdentifierTypeStateIssuer
1119407MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Northwest la Incs LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700901683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 METRO DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711096001",
            "telephone_number": "318-636-0390",
            "fax_number": "318-635-3298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 METRO DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711096001",
            "telephone_number": "318-636-0390",
            "fax_number": "318-635-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST LA INCS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "REGIONAL COORDINATOR",
        "authorized_official_telephone_number": "318-636-0390",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "LA",
            "license": "11761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1119407",
            "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 Aug 22, 2020; 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.