Highland Clinic, a Prof Med Corp

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

HIGHLAND CLINIC, A PROF MED CORP

Practice address

5025 Shed Rd
Bossier City, LA 71111-5434

Phone

(318) 795-4741

Fax

(318) 795-4742

NPI assigned

Sep 24, 2020

Last updated

Jun 2, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael Gustavson

Title

Administrator

Phone

(318) 798-4465

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Highland Clinic, a Prof Med Corp

  • Multi-Specialty Clinic/Center
  • Shreveport, LA
  • NPI 1053315846

  3870493463

  Same PAC ID
• Highland Clinic, a Prof Med Corp

  • Non-Pharmacy Dispensing Site
  • Shreveport, LA
  • NPI 1609297449

  3870493463

  Same PAC ID
• Highland Clinic, a Prof Med Corp

  • Orthopaedic Surgery Physician
  • Shreveport, LA
  • NPI 1700259678

  3870493463

  Same PAC ID

Tax ID family

Highland Clinic Laborat3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Highland Clinic, a Prof Med Corp

  • Non-Pharmacy Dispensing Site
  • Shreveport, LA
  • NPI 1609297449
  NPD tax ID
• Highland Clinic, a Prof Med Corp

  • Orthopaedic Surgery Physician
  • Shreveport, LA
  • NPI 1700259678
  NPD tax ID

Locations

Practitioners 75

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.

• Lakeisha Allen

  • Family Nurse Practitioner
  • Shreveport, LA
  • NPI 1902670177
  NPD
• Gonzalo Alvarez del Real, MD

  • Allergy & Immunology Physician
  • Shreveport, LA
  • NPI 1801853106
  NPD
• Paul Allen Ballard, PA-C, ATC

  • Physician Assistant
  • Bossier City, LA
  • NPI 1114445798
  NPD
• James R Barnes, M.D.

  • Surgery Physician
  • Shreveport, LA
  • NPI 1033158837
  NPD
• Robert Baye, PA-C

  • Physician Assistant
  • Shreveport, LA
  • NPI 1780607549
  NPD
• Sadie McCallister Beebe, PA-C

  • Physician Assistant
  • Shreveport, LA
  • NPI 1801182258
  NPD
• Dea Bekteshi, OD

  • Optometrist
  • Shreveport, LA
  • NPI 1316614365
  NPD
• Anand Krishna Bhat, M.D.

  • Allergy & Immunology (Internal Medicine) Physician
  • Shreveport, LA
  • NPI 1992084750
  NPD
• Gabrielle Gandy Boyd, OD

  • Optometrist
  • Shreveport, LA
  • NPI 1730687260
  NPD
• Claude Youngblood Bundrick Jr., MD

  • Ophthalmology Physician
  • Shreveport, LA
  • NPI 1043538796
  NPD
• Russell D Burlison, MD

  • Obstetrics & Gynecology Physician
  • Shreveport, LA
  • NPI 1073517975
  NPD
• Paul Butts, PA-C

  • Physician Assistant
  • Shreveport, LA
  • NPI 1598427411
  NPD

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1740897743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 E BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055634",
            "telephone_number": "318-798-4500",
            "fax_number": "318-798-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5025 SHED RD",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115434",
            "telephone_number": "318-795-4741",
            "fax_number": "318-795-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND CLINIC, A PROF MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "GUSTAVSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-798-4465",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Hicks
• Eumarcus Hicks
• Junita Hicks
• Donna A Hidalgo, LCSW, C-SSWS
• Karl Wayne Higginbotham, PT
• Amanda D Hikes, RPH
• Hill-Rom Company, Inc
• Amy Hill
• Emily Marie Hill, BCBA
• Joshua Hill

• Orthopaedic Surgery Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Orthopaedic Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.