Active NPI
Daniel J. Moller Jr., MD
- Internal Medicine Physician
- Shreveport, LA
National Provider Identifier
1760428528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 012335
- Practice address
- 8001 Youree Dr
Suite 400
Shreveport, LA 71115-2302 - Phone
- (318) 212-3456
- Fax
- (318) 212-3885
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 012335 | LA | Primary |
Addresses
Primary practice location
8001 Youree Dr
Suite 400
Shreveport, LA 71115-2302
Mailing address
8001 Youree Dr
Suite 400
Shreveport, LA 71115-2302
Phone (318) 212-3456
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1159859 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012335 | LA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1760428528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8001 YOUREE DR",
"address_2": "SUITE 400",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711152302",
"telephone_number": "318-212-3456",
"fax_number": "318-212-3885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8001 YOUREE DR",
"address_2": "SUITE 400",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711152302",
"telephone_number": "318-212-3456",
"fax_number": "318-212-3885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLLER",
"first_name": "DANIEL",
"middle_name": "J.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "LA",
"license": "012335",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1159859",
"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 Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.