Organization Active NPI

Sureaccess, MD, LLC

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1821034679
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14448R Issued in LA
Legal business name
SUREACCESS, MD, LLC
Practice address
725 N Ashley Ridge Loop
#100
Shreveport, LA 71106-7232
Phone
(318) 935-6177
Fax
(888) 627-6744
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Authorized official

Name
Dr. Richard J. Michael, MDNPI 1861496671
Title
MD
Phone
(318) 935-6177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 13626R LA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 14448R LA Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 13626R LA

Addresses

Primary practice location

725 N Ashley Ridge Loop
#100
Shreveport, LA 71106-7232

Mailing address

725 N Ashley Ridge Loop
#100
Shreveport, LA 71106-7232
Phone (318) 935-6177

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060726000391 LA Part B Supplier - Clinic/Group Practice 2567475130 Receives reassigned benefits from 4 practitioners
Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory

Locations

725 N Ashley Ridge Loop
Ste 100
Shreveport, LA 71106
Phone (318) 290-2122

1534 Elizabeth Ave
Ste 401A
Shreveport, LA 71101
Phone (318) 431-8613

1500 Line Ave
Ste 204
Shreveport, LA 71101
Phone (318) 629-5001

8525 Line Ave
Ste A
Shreveport, LA 71106
Phone (318) 300-4926

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1821034679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 N ASHLEY RIDGE LOOP",
            "address_2": "#100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067232",
            "telephone_number": "318-935-6177",
            "fax_number": "888-627-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N ASHLEY RIDGE LOOP",
            "address_2": "#100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067232",
            "telephone_number": "318-935-6177",
            "fax_number": "888-627-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUREACCESS, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "318-935-6177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "13626R",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "14448R",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "13626R",
            "primary": false
        }
    ],
    "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 Aug 4, 2015; 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.