Individual provider Active NPI

John Davidson Gladney, MD

  • Surgery Physician
  • Shreveport, LA
National Provider Identifier
1821054214
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
L015042 Issued in LA
Practice address
8001 Youree Drive
Suite 840
Shreveport, LA 71115-2302
Phone
(318) 795-9100
Fax
(318) 222-8889
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X L015042 LA Primary

Addresses

Primary practice location

8001 Youree Drive
Suite 840
Shreveport, LA 71115-2302

Mailing address

8001 Youree Drive
Suite 840
Shreveport, LA 71115-2302
Phone (318) 795-9100

Other identifiers 1

IdentifierTypeStateIssuer
1362395MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L015042LAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Surgical Consultants Surgery Past Accepting new patients
Gladney Marler & Associates ,LLC PastSince Jan 1, 2007 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1821054214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DRIVE",
            "address_2": "SUITE 840",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-795-9100",
            "fax_number": "318-222-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DRIVE",
            "address_2": "SUITE 840",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-795-9100",
            "fax_number": "318-222-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADNEY",
        "first_name": "JOHN",
        "middle_name": "DAVIDSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "L015042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1362395",
            "state": "LA"
        }
    ],
    "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 Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.