Individual provider Active NPI

Heidi Elaine Henson

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1760977573
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
340350 Issued in LA
Practice address
2551 Greenwood Rd Ste 410
Shreveport, LA 71103-3989
Phone
(318) 621-2929
Fax
(318) 621-2930
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 340350 LA Primary
Obesity Medicine (Internal Medicine) Physician 207RB0002X 340350 LA

Addresses

Primary practice location

2551 Greenwood Rd Ste 410
Shreveport, LA 71103-3989

Mailing address

2551 Greenwood Rd Ste 410
Shreveport, LA 71103-3989
Phone (318) 621-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, LA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210826003331 CA Practitioner - Internal Medicine 2668877796 Reassigns benefits to 1 organization
I20240724002640 LA Practitioner - Internal Medicine 2668877796 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
WK Tri-State Medical ClinicGroup PAC ID 0143225128, 13 clinicians
WK Academic Medicine ClinicGroup PAC ID 4688078371, 6 clinicians

Practice addresses (Care Compare)

2551 Greenwood Rd
Suite 410
Shreveport, LA 71103-3989
Phone (318) 621-2929

2751 Albert L Bicknell Dr
Suite 2D
Shreveport, LA 71103-3939
Phone (318) 212-4232

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
17947CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
WK Tri-State Medical Clinic Internal Medicine CurrentSince Jun 24, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
WK Academic Medicine Clinic Internal Medicine CurrentSince Aug 20, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 12, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 12, 2022 Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

2551 Greenwood Rd
Ste 410
Shreveport, LA 71103
Phone (318) 621-2929

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

2751 Albert L Bicknell Dr
Ste 2D
Shreveport, LA 71103
Phone (318) 212-4232

Organizations & group practices 5

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1760977573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD RD STE 410",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033989",
            "telephone_number": "318-621-2929",
            "fax_number": "318-621-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD RD STE 410",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033989",
            "telephone_number": "318-621-2929",
            "fax_number": "318-621-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "HEIDI",
        "middle_name": "ELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "340350",
            "primary": true
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "LA",
            "license": "340350",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.