Northwest Louisiana Physical Medicine

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

NORTHWEST LOUISIANA PHYSICAL MEDICINE

Practice address

9045 Ellerbe Rd Ste 107
Shreveport, LA 71106-6799

Phone

(318) 424-4224

Fax

(318) 865-5330

NPI assigned

Aug 26, 2005

Organization subpart

No

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

Authorized official

Name

Jenness Courtney, MDNPI 1811980675

Title

President

Phone

(318) 424-4224

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 4

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

• Jenness Doniphan Courtney III, MD

  • Physical Medicine & Rehabilitation Physician
  • Shreveport, LA
  • NPI 1811980675
  Medicare reassignment NPD Authorized official
• John M White, PA-C

  • Medical Physician Assistant
  • Shreveport, LA
  • NPI 1558389833
  Medicare reassignment
• James Wright Brooks II, CFNP/APRN

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1508843541
  NPD (past)
• Marsha Louise Murray, CFNP

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1437142247
  NPD (past)

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1720071590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 FAIRFIELD AVE",
            "address_2": "STE 411",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014443",
            "telephone_number": "318-424-4224",
            "fax_number": "318-424-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9045 ELLERBE RD STE 107",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066799",
            "telephone_number": "318-424-4224",
            "fax_number": "318-865-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST LOUISIANA PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "COURTNEY",
        "authorized_official_first_name": "JENNESS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-424-4224",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest la Incs, LLC
• Northwest la Incs, LLC
• Northwest Louisiana Behavioral Health System
• Northwest Louisiana Intensivists LLC
• Northwest Louisiana Nephrology, LLC
• Northwest Lousiana Human Services District
• Northwest Lousiana Human Services District
• Northwest Regional Transportation
• Northwest Surgical Specialists Inc.
• Matthew Norton

• Physical Medicine & Rehabilitation Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physical Medicine & Rehabilitation Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.