Magnolia Diagnostic Services Inc.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MAGNOLIA DIAGNOSTIC SERVICES INC.

Practice address

4005 Lakeshore Dr
Shreveport, LA 71109-1927

Phone

(318) 840-9074

NPI assigned

May 19, 2025

Last updated

May 22, 2025By 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

Mr. Dewarrent Lee Brantley

Title

Ceo/Owner

Phone

(318) 840-9074

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Rosalind Annette Cropper, MD

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1124243837
  NPD
• Darlinda Theresa Dove, FNP

  • Family Nurse Practitioner
  • Glenmora, LA
  • NPI 1003329871
  NPD

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1770375768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 LAKESHORE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711091927",
            "telephone_number": "318-840-9074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 LAKESHORE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711091927",
            "telephone_number": "318-840-9074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA DIAGNOSTIC SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "DEWARRENT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "318-840-9074",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Prince Maggio, LOTR
• Christopher Micheal Magill, PA-C
• Nan Magness, LPC
• Magnolia Community Mental Health Facility Inc.
• Magnolia Comprehensive Outpatient Rehabiliation Facility Inc.
• Magnolia Diagonstic Services Inc.
• Magnolia Durable Medical Equipment Inc.
• Magnolia Family Support & Interventions, LLC
• Magnolia Intergrated Healthcare Services Inc
• Magnolia Manor Nursing & Rehab CNTR LLC (Magnolia Manor Nursing & Rehabilitation Center)

• Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.