Willis-Knighton Medical Center, Inc.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

WILLIS-KNIGHTON MEDICAL CENTER, INC.

Practice address

2508 Bert Kouns Loop
Suite 105
Shreveport, LA 71118-3133

Phone

(318) 212-8780

Fax

(318) 212-6752

NPI assigned

Feb 7, 2012

Organization subpart

Yes

Parent organization

WILLIS-KNIGHTON MEDICAL CENTER, INC.As reported in NPPES

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) 212-4232

Specialties & licenses 1

Addresses

Other names 1

• A WK Clinic for Women - South Doing business as

Tax ID family

Willis Knighton South H19 organizations share this tax ID, including this one

Part of

Willis Knighton South H

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

• Willis Knighton Health System

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1629193057
  NPD tax ID
• Willis Knighton Medical Center, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Shreveport, LA
  • NPI 1003020579
  NPD tax ID
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  NPD tax ID
• Willis Knighton Medical Center, Inc.

  • Skilled Nursing Facility
  • Shreveport, LA
  • NPI 1144267451
  NPD tax ID
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  NPD tax ID
• Willis Knighton Medical Center, Inc.

  • Home Health Agency
  • Shreveport, LA
  • NPI 1326093782
  NPD tax ID
• Willis Knighton Medical Center, Inc.

  • Corporate Health Clinic/Center
  • Shreveport, LA
  • NPI 1326821877
  NPD tax ID
• Willis Knighton Medical Center, Inc.

  • Community Based Hospice Care Agency
  • Shreveport, LA
  • NPI 1487693149
  NPD tax ID
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  NPD tax ID
• Willis Knighton Medical Center, Inc.

  • Rehabilitation Hospital Unit
  • Shreveport, LA
  • NPI 1710039896
  NPD tax ID
• Willis Knighton Medical Center, Inc.

  • Clinical Medical Laboratory
  • Shreveport, LA
  • NPI 1730645201
  NPD tax ID
• Willis Knighton Medical Center, Inc.

  • Psychiatric Hospital Unit
  • Shreveport, LA
  • NPI 1912059932
  NPD tax ID

Locations

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1790057735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 BERT KOUNS LOOP",
            "address_2": "SUITE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183133",
            "telephone_number": "318-212-8780",
            "fax_number": "318-212-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 BERT KOUNS LOOP",
            "address_2": "SUITE 105",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183133",
            "telephone_number": "318-212-8780",
            "fax_number": "318-212-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIS-KNIGHTON MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIS-KNIGHTON MEDICAL CENTER, INC.",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "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": "318-212-4232"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A WK Clinic for Women - South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Willis-Knighton Medical Center & Johnston Johnny MD
• Willis-Knighton Medical Center Michelle Self MD
• Willis-Knighton Medical Center, Inc
• Willis-Knighton Medical Center, Inc.
• Willis-Knighton Medical Center, Inc.
• Willis-Knighton Medical System
• Brandy Willis
• Brian Keith Willis, M.D.
• Cedric R Willis, PA-C
• Chase Kylen Willis

• All providers in Shreveport, LA
• Obstetrics & Gynecology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.