Ken Stanley MD and Willis-Knighton Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KEN STANLEY MD AND WILLIS-KNIGHTON MEDICAL CENTER

Practice address

2551 Greenwood Rd
Suite 310
Shreveport, LA 71103-3981

Phone

(318) 212-8780

Fax

(318) 212-4153

NPI assigned

Jul 6, 2006

Last updated

Aug 22, 2020By 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

Greg J Gavin

Title

Network Administrator

Phone

(318) 212-8780

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770515553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD RD",
            "address_2": "SUITE 310",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033981",
            "telephone_number": "318-212-8780",
            "fax_number": "318-212-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD RD",
            "address_2": "SUITE 310",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033981",
            "telephone_number": "318-212-8780",
            "fax_number": "318-212-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEN STANLEY MD AND WILLIS-KNIGHTON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NETWORK ADMINISTRATOR",
        "authorized_official_telephone_number": "318-212-8780"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Kelm, DDS, MD
• Cassandra Anne Kemmerer, LPC,LMFT
• Susan Elizabeth Kemp, MD
• Abbie Creighton Kemper, M.D.
• Candace Capelan Kemper, PT
• Jazzelyn Kendrick, MSN, FNP
• Terry Wayne Kendrick, MD
• Aliyah Kennedy
• Ceraya Elonna Kennedy
• Felicia Hullaby Kennedy

• Family Medicine Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.