WK Preferred Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

WK PREFERRED PEDIATRICS

Practice address

2300 Hospital Dr Ste 120
Bossier City, LA 71111-2193

Phone

(318) 212-7982

Fax

(318) 212-7989

NPI assigned

Jun 24, 2019

Last updated

Jun 24, 2019By 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

Matthew Wheeler

Title

Revenue Contract Manager

Phone

(318) 212-8299

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572

  Member Of

  NPD member

Locations

Practitioners 5

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.

• Sarah Rainwater

  • Pediatrics Physician
  • Bossier City, LA
  • NPI 1093212748
  Medicare reassignment
• Randall Glen White Jr., MD

  • Pediatrics Physician
  • Bossier City, LA
  • NPI 1295199016
  Medicare reassignment
• Robert Borden Wilson, M.D.

  • Pediatrics Physician
  • Bossier City, LA
  • NPI 1477971885
  Medicare reassignment
• Pierre Valmont Blanchard, MD

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1104889237
  NPD (past)
• Elise Fontenot Edwards, MD

  • Pediatrics Physician
  • Bossier City, LA
  • NPI 1780048587

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561334400000",
    "number": "1760043491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-212-8951",
            "fax_number": "318-212-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR STE 120",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112193",
            "telephone_number": "318-212-7982",
            "fax_number": "318-212-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK PREFERRED PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "REVENUE CONTRACT MANAGER",
        "authorized_official_telephone_number": "318-212-8299"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WK Internal Medicine and Pediatric Specialists
• WK Louisiana Family Practice
• WK Neurology Clinic
• WK North Bossier ENT
• WK Precision Neurosurgery
• WK Premier Pediatrics
• WK Red River Internal Medicine
• WK Spine & Pain Specialists
• WK Swan Lake Diabetes & Endocrinology
• WK Urgent Care Center - Bossier

• Pediatrics Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.