Individual provider Active NPI

Mary Ann Edens, MD

  • Emergency Medicine Physician
  • Shreveport, LA
National Provider Identifier
1801820121
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
14229R Issued in LA
Practice address
1501 King's Highway
Shreveport, LA 71103
Phone
(318) 675-6885
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 54610 GA
Emergency Medicine Physician 207P00000X 14229R LA Primary

Addresses

Primary practice location

1501 King's Highway
Shreveport, LA 71103

Mailing address

1501 King's Highway
Shreveport, LA 71103
Phone (318) 675-6885

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
I20100513000781 LA Practitioner - Emergency Medicine 8224018056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54610GAMDEmergency Medicine Physician
14229RLAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Emergency Medicine CurrentSince Dec 1, 2016 Accepting new patients
C & M Medical Services, Inc. Past Accepting new patients

Locations

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

Interoperability endpoints

  • Direct secure messaging: medens778320@direct.ochsner.org

Organizations & group practices 2

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

Hospital & facility affiliations 1

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1801820121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KING'S HIGHWAY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71103",
            "telephone_number": "318-675-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KING'S HIGHWAY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71103",
            "telephone_number": "318-675-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDENS",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "54610",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "14229R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.