WK Internal Medicine and Pediatric Specialists

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WK INTERNAL MEDICINE AND PEDIATRIC SPECIALISTS

Practice address

5751 Shed Rd Ste 120
Bossier City, LA 71111-5662

Phone

(318) 935-1922

Fax

(318) 935-1925

NPI assigned

Feb 26, 2015

Organization subpart

No

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

Authorized official

Name

Jared Beville

Title

VP Physician Network

Phone

(318) 716-4891

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Willis Knighton Medical Center, Inc.

  • Skilled Nursing Facility
  • Shreveport, LA
  • NPI 1144267451

  Member Of

  NPD member

Locations

Practitioners 3

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

• Jennifer Kelley, MD

  • Internal Medicine Physician
  • Bossier City, LA
  • NPI 1366760993

  Internal Medicine, LA

  Medicare reassignment Care Compare group NPD
• Cheynita Metoyer, MD

  • Internal Medicine Physician
  • Bossier City, LA
  • NPI 1336405935

  Internal Medicine, LA

  Medicare reassignment Care Compare group NPD
• Jessica Carter Tubbs, WHNP-C

  • Nurse Practitioner
  • Bossier City, LA
  • NPI 1801082920

  LA

  Medicare reassignment NPD

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1851783955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 SHED RD STE 120",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115662",
            "telephone_number": "318-935-1922",
            "fax_number": "318-935-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 SHED RD STE 120",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115662",
            "telephone_number": "318-935-1922",
            "fax_number": "318-935-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK INTERNAL MEDICINE AND PEDIATRIC SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "BEVILLE",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "VP PHYSICIAN NETWORK",
        "authorized_official_telephone_number": "318-716-4891"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WK Center for Ear Nose and Throat Disorders
• WK Ctr for Ear Nose and Throat Disorders
• WK Dermatology Clinic
• WK Endocrine Specialists
• WK Haughton Medical Group
• WK Louisiana Family Practice
• WK Neurology Clinic
• WK North Bossier ENT
• WK Precision Neurosurgery
• WK Preferred Pediatrics

• All providers in Bossier City, LA
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.