NPIMap

Organization Active NPI

WKMC Cardiovascular Consultants

  • Cardiovascular Disease Physician
  • Shreveport, LA
National Provider Identifier
1801205802
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
WKMC CARDIOVASCULAR CONSULTANTS
Practice address
2727 Hearne Ave Ste 301
Shreveport, LA 71103-3918
Phone
(318) 631-6400
Fax
(318) 631-0300
NPI assigned
Aug 5, 2014
Last updated
Jul 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Authorized official

Name
Mary Jane Ward
Title
Sr. VP of Finance
Phone
(318) 716-4937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

2727 Hearne Ave Ste 301
Shreveport, LA 71103-3918

Mailing address

2727 Hearne Ave Ste 301
Shreveport, LA 71103-3918
Phone (186) 316-4003

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141013000521 LA Part B Supplier - Clinic/Group Practice 0941420061 Receives reassigned benefits from 39 practitioners
Practice locations: Minden, LA; Vivian, LA; Shreveport, LA; Ruston, LA; Natchitoches, LA; Homer, LA; 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

1029 Keyser Ave
Ste M
Natchitoches, LA 71457

1029 Keyser Ave
Ste N
Natchitoches, LA 71457
Phone (800) 256-1100

1809 Northpointe Ln
Ste 130
Ruston, LA 71270

2313 Common Ct
Ste 56
Ruston, LA 71270
Phone (318) 232-7782

2520 Bert Kouns Industrial Loop
Ste 105
Shreveport, LA 71118
Phone (318) 212-5520

2727 Hearne Ave
Ste 301
Shreveport, LA 71103

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1801205802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 HEARNE AVE STE 301",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033918",
            "telephone_number": "186-316-4003",
            "fax_number": "318-631-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 HEARNE AVE STE 301",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033918",
            "telephone_number": "318-631-6400",
            "fax_number": "318-631-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WKMC CARDIOVASCULAR CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-05",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "SR. VP OF FINANCE",
        "authorized_official_telephone_number": "318-716-4937"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.