NPIMap

Organization Active NPI

Pulmonary & Critical Care Specialists, L.L.C.

  • Specialist
  • Shreveport, LA
National Provider Identifier
1730156845
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
00181035 Issued in LA
Legal business name
PULMONARY & CRITICAL CARE SPECIALISTS, L.L.C.
Practice address
7829 Youree Dr
Shreveport, LA 71105-5505
Phone
(318) 797-8777
NPI assigned
Mar 7, 2006
Last updated
Apr 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Gladys T Bush, CCMA
Title
Administrator
Phone
(318) 797-8777

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 00181035 LA Primary
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

7829 Youree Dr
Shreveport, LA 71105-5505

Mailing address

7829 Youree Dr
Shreveport, LA 71105-5505
Phone (318) 797-8777

Other identifiers 1

IdentifierTypeStateIssuer
1440540MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060405000463 LA Part B Supplier - Clinic/Group Practice 9830107614 Receives reassigned benefits from 5 practitioners
Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory

Locations

7829 Youree Dr
Shreveport, LA 71105
Phone (318) 212-3890

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": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1730156845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7829 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055505",
            "telephone_number": "318-797-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7829 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055505",
            "telephone_number": "318-797-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY & CRITICAL CARE SPECIALISTS, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "GLADYS",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-797-8777",
        "authorized_official_credential": "CCMA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "00181035",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1440540",
            "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 Apr 27, 2022; 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.