Individual provider Active NPI

Charles W Webb, DO

  • Sports Medicine (Family Medicine) Physician
  • Shreveport, LA
National Provider Identifier
1811967235
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
324896 Issued in LA
Practice address
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 626-0000
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 324896 LA Primary
Sports Medicine (Family Medicine) Physician 207QS0010X K-O568 TX

Addresses

Primary practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1512 W Kirby PL
Shreveport, LA 71103-3822
Phone (318) 626-0287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070529000217 OR Practitioner - Sports MedicinePractitioner - Family Practice 4284648452 Reassigns benefits to 1 organization
I20201110002831 LA Practitioner - Sports MedicinePractitioner - Family Practice 4284648452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 1995
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

  • Ochsner Lsu Health Shreveport-St Mary Medical Cent Hospital, Shreveport, LA, CCN 190317
  • Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098
  • Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K-O568TXMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Jan 1, 2018 Accepting new patients
Legacy Clinics LLC CurrentSince Jan 1, 2018 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Nov 9, 2020 Accepting new patients
Uptown Providers Inc PastSince May 1, 2016 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

4481 Viking Dr
Bossier City, LA 71111
Phone (318) 626-2593

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

1023 Provenance Pl
Ste 130
Shreveport, LA 71106
Phone (318) 626-0100

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

950 Olive St
Shreveport, LA 71104
Phone (318) 221-1581

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

6670 Saint Vincent Ave
Shreveport, LA 71106
Phone (318) 626-0500

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1960 NW 167th Pl
Ste 200
Beaverton, OR 97006
Phone (503) 413-4488

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

Interoperability endpoints

  • Direct secure messaging: cwebb1151853@direct.ochsner.org

Organizations & group practices 5

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 4

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1811967235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W KIRBY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033822",
            "telephone_number": "318-626-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "CHARLES",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "LA",
            "license": "324896",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "K-O568",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.