Active NPI
David A Cavanaugh, MD
- Neurological Surgery Physician
- Shreveport, LA
National Provider Identifier
1821080672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 16318
- Practice address
- 1500 Line Avenue
Ste 200
Shreveport, LA 71101 - Phone
- (318) 629-5555
- Fax
- (318) 629-5556
- NPI assigned
- Aug 18, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 16318 | LA | Primary |
Addresses
Primary practice location
1500 Line Avenue
Ste 200
Shreveport, LA 71101
Mailing address
1500 Line Avenue
Ste 204
Shreveport, LA 71101
Phone (318) 629-5001
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16318 | LA | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Musculoskeletal Institute of Louisiana, LLC | Past | Accepting new patients | |
| Surgical Specialty Center, LLC | Past | 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.
-
- Pain Medicine (Anesthesiology) Physician
- Shreveport, LA
- NPI 1003920232
-
- Ambulatory Surgical Clinic/Center
- Shreveport, LA
- NPI 1316970916
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1821080672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 LINE AVENUE",
"address_2": "STE 204",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "71101",
"telephone_number": "318-629-5001",
"fax_number": "318-629-5020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 LINE AVENUE",
"address_2": "STE 200",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "71101",
"telephone_number": "318-629-5555",
"fax_number": "318-629-5556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVANAUGH",
"first_name": "DAVID",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-18",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "LA",
"license": "16318",
"primary": true
}
],
"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 Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.