WK Allergy and Asthma Clinic

Primary specialty

Clinical & Laboratory Immunology (Allergy & Immunology) PhysicianTaxonomy code 207KI0005X

Legal business name

WK ALLERGY AND ASTHMA CLINIC

Practice address

2300 Hospital Dr Ste 345
Bossier City, LA 71111-2194

Phone

(318) 227-7946

NPI assigned

Sep 6, 2016

Organization subpart

No

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

Authorized official

Name

Greg J Gavin

Title

Managed Care Credentialing

Phone

(318) 212-8951

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Member of 1

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

• Willis Knighton Medical Center, Inc.

  dba WK Extended Care Center

  • Skilled Nursing Facility
  • Shreveport, LA
  • NPI 1144267451

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Bryan Boggs, M.D.

  • Clinical & Laboratory Immunology (Allergy & Immunology) Physician
  • Bossier City, LA
  • NPI 1447217252
  Medicare reassignment NPD

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1760939987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR",
            "address_2": "SUITE 110",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112394",
            "telephone_number": "318-227-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR STE 345",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112194",
            "telephone_number": "318-227-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK ALLERGY AND ASTHMA CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-06",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGED CARE CREDENTIALING",
        "authorized_official_telephone_number": "318-212-8951"
    },
    "taxonomies": [
        {
            "code": "207KI0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winn Community Health Center, Inc. (Bossier Community Health Center)
• Lauryn Winn
• Jacqueline Yvette Winston
• James Allen Wiseman, D.C.
• WK Advanced Urology
• WK and Bone & Joint Clinic - Bossier
• WK and the Asthma-Allergy Clinic
• WK Arklatex Urology and Prostate Cancer Institute
• WK Behavioral Health Medical Center
• WK Behavorial Health Med Center

• Allergy & Immunology Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Allergy & Immunology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.