Patricia Webb, NP

Individual provider Active NPI Nurse Practitioner · Plain Dealing, LA

NPI 1720164379 · NPPES record last updated Sep 28, 2012

Key facts

NPI
1720164379
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
2005007456 (LA)
Practice address
112 Forest Street
Plain Dealing, LA 71064
Phone
(318) 326-7272
Fax
(318) 326-7282
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Council for Advancement of Social Service and Education (10 clinicians)

Practice addresses (Care Compare)

2120 Bert Kouns Industrial Loop
Shreveport, LA 71118-3351
Phone 31868833501230

907 Polk St
Mansfield, LA 71052-2520
Phone (318) 688-3350

Hospital & facility affiliations

  • Willis Knighton Medical Center Hospital · Shreveport, LA · CCN 190111

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20070224000124 LA Practitioner - Nurse Practitioner 4284736026 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2005007456LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Council for Advancement of Social Service and Education Current
since Jul 1, 2019
Accepting new patients
Council for Advancement of Social Service and Education Current
since Jul 1, 2019
Accepting new patients
Council for Advancement of Social Service and Education Current Accepting new patients
Council for Advancement of Social Service and Education Past
since Aug 2, 2020
Accepting new patients

Locations

907 Polk St
Mansfield, LA 71052
Phone (318) 688-3350

2120 Bert Kouns Industrial Loop
Ste Kl
Shreveport, LA 71118
Phone (318) 688-3350

2120 Bert Kouns Industrial Loop
Ste H
Shreveport, LA 71118

1560 Irving Pl
Shreveport, LA 71101
Phone (318) 212-1194

2120 Bert Kouns Industrial Loop
Ste A
Shreveport, LA 71118
Phone (318) 688-3350

149 Stone Creek Rd
Stonewall, LA 71078
Phone (318) 688-3350

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2005007456 LA Yes

Addresses

Primary practice location

112 Forest Street
Plain Dealing, LA 71064

Mailing address

1003 S Spruce St
Vivian, LA 71082-3200
Phone (318) 375-4003

Other identifiers

IdentifierTypeStateIssuer
1444286MedicaidLA
2302639MedicaidLA
1370215MedicaidLA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 28, 2012.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1720164379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 S SPRUCE ST",
            "city": "VIVIAN",
            "state": "LA",
            "postal_code": "710823200",
            "telephone_number": "318-375-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 FOREST STREET",
            "city": "PLAIN DEALING",
            "state": "LA",
            "postal_code": "71064",
            "telephone_number": "318-326-7272",
            "fax_number": "318-326-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "PATRICIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "2005007456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1444286",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2302639",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1370215",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plain Dealing, LA

All providers in Plain Dealing, LA · Nurse Practitioner in Louisiana

Sources for this page

Verify at the official NPI Registry.