NPIMap

Organization Active NPI

WK Womens Health Associates

  • Obstetrics & Gynecology Physician
  • Bossier City, LA
National Provider Identifier
1790790467
Registry record updated Jun 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WK WOMENS HEALTH ASSOCIATES
Practice address
2400 Hospital Dr
Suite 240
Bossier City, LA 71111-2385
Phone
(318) 742-5800
Fax
(318) 741-3902
NPI assigned
Jul 30, 2006
Last updated
Jun 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2012

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

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

2400 Hospital Dr
Suite 240
Bossier City, LA 71111-2385

Mailing address

2400 Hospital Dr
Suite 240
Bossier City, LA 71111-2385
Phone (318) 742-5800

Other identifiers 1

IdentifierTypeStateIssuer
1448966MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061113000050 LA Part B Supplier - Clinic/Group Practice 2668470345 Receives reassigned benefits from 7 practitioners
Practice locations: Bossier City, LA

National Provider Directory

National Provider Directory

Member of 1

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

Locations

2400 Hospital Dr
Ste 240
Bossier City, LA 71111
Phone (318) 742-1795

Practitioners & affiliated clinicians

Practitioners 12

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": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1790790467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 HOSPITAL DR",
            "address_2": "SUITE 240",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112385",
            "telephone_number": "318-742-5800",
            "fax_number": "318-741-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HOSPITAL DR",
            "address_2": "SUITE 240",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112385",
            "telephone_number": "318-742-5800",
            "fax_number": "318-741-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK WOMENS HEALTH ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2012-06-08",
        "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": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1448966",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.