NPIMap

Organization Active NPI

Bone & Joint Clinic

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Shreveport, LA
National Provider Identifier
1710095690
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
09700 Issued in LA
Legal business name
BONE & JOINT CLINIC
Practice address
1202 Louisiana Ave
Shreveport, LA 71101-3910
Phone
(318) 425-8701
NPI assigned
Aug 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Mr. Wayne Smith, MANAGER
Title
Administrator
Phone
(318) 425-8701

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X 09700 LA Primary

Addresses

Primary practice location

1202 Louisiana Ave
Shreveport, LA 71101-3910

Mailing address

1202 Louisiana Ave
Shreveport, LA 71101-3910
Phone (318) 425-8701

National Provider Directory

National Provider Directory

Locations

2449 Hospital Dr
Ste 200
Bossier City, LA 71111
Phone (318) 212-7841

4601 Westbank Expy
Marrero, LA 70072
Phone (504) 347-5421

2600 Belle Chasse Hwy
Ste 1
Terrytown, LA 70056
Phone (504) 391-7670

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710095690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-425-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-425-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONE & JOINT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-425-8701",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MANAGER"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "LA",
            "license": "09700",
            "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 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.