Individual provider Active NPI

Chance Queen, PA

  • Physician Assistant
  • Shreveport, LA
National Provider Identifier
1760270052
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
8001 Youree Dr
Shreveport, LA 71115-2302
Phone
(318) 212-3000
NPI assigned
Apr 28, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

8001 Youree Dr
Shreveport, LA 71115-2302

Mailing address

359 Avondale LN
Bossier City, LA 71112-4247
Phone (318) 541-6882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260112001976 LA Practitioner - Physician Assistant 0244716033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cross Lake Emergency Group, LLCGroup PAC ID 5395096440, 60 clinicians

Practice addresses (Care Compare)

2400 Hospital Dr
Bossier City, LA 71111-2385
Phone (318) 212-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Lake Emergency Group, LLC Physician Assistant CurrentSince Dec 7, 2025 Accepting new patients

Locations

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

2510 Bert Kouns Industrial Loop
Shreveport, LA 71118
Phone (318) 212-5000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1760270052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 AVONDALE LN",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711124247",
            "telephone_number": "318-541-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-212-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "CHANCE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.