NPIMap

Organization Active NPI

West State Orthopedics and Sports Medicine Clinic

  • Orthopaedic Surgery Physician
  • Leesville, LA
National Provider Identifier
1720037922
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
11865R Issued in LA
Legal business name
WEST STATE ORTHOPEDICS AND SPORTS MEDICINE CLINIC
Practice address
506 S 6TH St
Suite B
Leesville, LA 71446-4442
Phone
(337) 392-2330
Fax
(337) 392-2580
NPI assigned
May 8, 2006
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
Shawn Patrick Granger, M.D.NPI 1609825165
Title
Physician / Owner
Phone
(337) 392-2330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 11865R LA Primary

Addresses

Primary practice location

506 S 6TH St
Suite B
Leesville, LA 71446-4442

Mailing address

506 S 6TH St
Suite B
Leesville, LA 71446-4442
Phone (337) 392-2330

National Provider Directory

National Provider Directory

Locations

506 S 6th St
Ste B
Leesville, LA 71446
Phone (337) 238-1112

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720037922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 S 6TH ST",
            "address_2": "SUITE B",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464442",
            "telephone_number": "337-392-2330",
            "fax_number": "337-392-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 S 6TH ST",
            "address_2": "SUITE B",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464442",
            "telephone_number": "337-392-2330",
            "fax_number": "337-392-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST STATE ORTHOPEDICS AND SPORTS MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRANGER",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PHYSICIAN / OWNER",
        "authorized_official_telephone_number": "337-392-2330",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "11865R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, 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.