Organization Active NPI

WK Pierremont Neurology Clinic

  • Neurology Physician
  • Shreveport, LA
National Provider Identifier
1790390995
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
WK PIERREMONT NEUROLOGY CLINIC
Practice address
1811 E Bert Koun Loop Ste 200
Shreveport, LA 71105-5766
Phone
(318) 212-2720
NPI assigned
Sep 14, 2020
Last updated
Mar 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Authorized official

Name
Mrs. Mary Jane Ward
Title
Senior VP Finance
Phone
(318) 716-4891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X Primary

Addresses

Primary practice location

1811 E Bert Koun Loop Ste 200
Shreveport, LA 71105-5766

Mailing address

1811 E Bert Kouns Industrial Loop Ste 200
Shreveport, LA 71105-5766
Phone (318) 212-2720

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201007000223 LA Part B Supplier - Clinic/Group Practice 4082033287 Receives reassigned benefits from 8 practitioners
Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1811 E Bert Kouns Industrial Loop
Ste 200
Shreveport, LA 71105
Phone (318) 212-2720

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1790390995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055766",
            "telephone_number": "318-212-2720",
            "fax_number": "218-212-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUN LOOP STE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055766",
            "telephone_number": "318-212-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK PIERREMONT NEUROLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "SENIOR VP FINANCE",
        "authorized_official_telephone_number": "318-716-4891",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.