NPIMap

Individual provider Active NPI

Richard James Michael, MD

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1861496671
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.14448R Issued in LA
Practice address
1500 Line Ave Ste 204
Shreveport, LA 71101-4648
Phone
(318) 300-4926
Fax
(318) 383-3951
NPI assigned
Jun 9, 2005
Last updated
Jan 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 14448R LA
Internal Medicine Physician 207R00000X MD.14448R LA Primary

Addresses

Primary practice location

1500 Line Ave Ste 204
Shreveport, LA 71101-4648

Mailing address

1500 Line Ave Ste 204
Shreveport, LA 71101-4648
Phone (318) 300-4926

Other identifiers 1

IdentifierTypeStateIssuer
1125865MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060627000373 LA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 2062424559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Texas Medical School at Houston, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sureaccess, MD, LLCGroup PAC ID 2567475130, 3 clinicians
Cornerstone Therapy and Balance Center, LLCGroup PAC ID 0345397899, 98 clinicians

Practice addresses (Care Compare)

8525 Line Ave
Suite a
Shreveport, LA 71106-6105
Phone (318) 300-4926

8961 Youree Dr
Shreveport, LA 71115-3001
Phone (318) 671-8772

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WK Shreveport Internal Medicine Internal Medicine CurrentSince Jul 2, 2023 Accepting new patients
Sureaccess, MD, LLC Internal Medicine CurrentSince May 15, 2015 Accepting new patients
Wellness Pass by Luraguiz MD Current Accepting new patients
Highland Clinic, a Prof Med Corp Past Accepting new patients

Locations

1500 Line Ave
Ste 101
Shreveport, LA 71101
Phone (318) 424-3400

1449 E Bert Kouns Industrial Loop
Ste 100
Shreveport, LA 71105
Phone (318) 629-0220

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

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

Interoperability endpoints

  • Direct secure messaging: richard.michael@624849887363076.direct.elationemr.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1861496671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LINE AVE STE 204",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014648",
            "telephone_number": "318-300-4926",
            "fax_number": "318-383-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LINE AVE STE 204",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014648",
            "telephone_number": "318-300-4926",
            "fax_number": "318-383-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "RICHARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "14448R",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.14448R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1125865",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.