Active NPI
Gudrun Stock Walker, MD
- Diagnostic Radiology Physician
- Shreveport, LA
National Provider Identifier
1861439796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD018151
- Practice address
- 1 Saint Mary PL
Shreveport, LA 71101-4343 - Phone
- (318) 222-1149
- Fax
- (318) 425-2335
- NPI assigned
- May 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD018151 | LA | Primary |
Addresses
Primary practice location
1 Saint Mary PL
Shreveport, LA 71101-4343
Mailing address
PO Box 44123
Shreveport, LA 71134-4123
Phone (318) 222-1149
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1953741 | Medicaid | LA |
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 |
|---|---|---|---|
| MD018151 | LA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Clinic, a Prof Med Corp | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Shreveport, LA
- NPI 1053315846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266451200000",
"number": "1861439796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 44123",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711344123",
"telephone_number": "318-222-1149",
"fax_number": "318-425-2335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SAINT MARY PL",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711014343",
"telephone_number": "318-222-1149",
"fax_number": "318-425-2335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "GUDRUN",
"middle_name": "STOCK",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-31",
"last_updated": "2010-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "LA",
"license": "MD018151",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1953741",
"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 Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.