Individual provider Active NPI

Devanshi K. Jani, MD

  • Psychiatry Physician
  • Shreveport, LA
National Provider Identifier
1770794083
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
204138 Issued in LA
Practice address
1111 Line Ave FL 3
Shreveport, LA 71101-3841
Phone
(318) 716-4610
Fax
(318) 716-4690
NPI assigned
May 25, 2007
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 204138 LA Primary

Addresses

Primary practice location

1111 Line Ave FL 3
Shreveport, LA 71101-3841

Mailing address

1111 Line Ave FL 3
Shreveport, LA 71101-3841
Phone (318) 716-4610

Other identifiers 1

IdentifierTypeStateIssuer
00009MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20111111000228 LA Practitioner - Psychiatry 8325212293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
WK Center for Psychiatric SupportGroup PAC ID 6406972645, 8 clinicians

Practice addresses (Care Compare)

1111 Line Ave
Shreveport, LA 71101-3841
Phone (318) 716-4610

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204138LAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Center for Psychiatric Support Psychiatry CurrentSince Sep 1, 2019 Accepting new patients
Anesthesiology and Pain Management Past Accepting new patients
Life Changing Mental Health, LLC. Past Accepting new patients
Willis Knighton Medical Center, Inc. Past Accepting new patients
Kay Kennedy MD and Willis-Knighton Medical Center Psychiatry PastSince Oct 8, 2011 Accepting new patients
Willis Knighton Medical Center, Inc. Past Accepting new patients

Locations

1111 Line Ave
Fl 3
Shreveport, LA 71101
Phone (318) 212-8424

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

Interoperability endpoints

  • Direct secure messaging: djani@direct.wkhs.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1770794083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 LINE AVE FL 3",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013841",
            "telephone_number": "318-716-4610",
            "fax_number": "318-716-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LINE AVE FL 3",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013841",
            "telephone_number": "318-716-4610",
            "fax_number": "318-716-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANI",
        "first_name": "DEVANSHI",
        "middle_name": "K.",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "204138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00009",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.