Lauren Bridges

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Shreveport, LA

NPI 1861999310 · NPPES record last updated Apr 11, 2018

Key facts

NPI
1861999310
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1501 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 626-2274
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20221020001501 IL Practitioner - Pediatric Medicine 3577814177 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group Current
since Jul 24, 2022
Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

435 Maxine Dr
Ste 34
Morton, IL 61550
Phone (309) 263-2424

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1501 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 626-2274

Other providers in Shreveport, LA

All providers in Shreveport, LA · Student in an Organized Health Care Education/Training Program in Louisiana

Sources for this page

Verify at the official NPI Registry.