Individual provider Active NPI

John Anthony Vanchiere, MD/PHD

  • Pediatric Infectious Diseases Physician
  • Shreveport, LA
National Provider Identifier
1871673111
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
MD023912 Issued in LA
Practice address
1501 Kings Hwy # 5-303
Shreveport, LA 71103-4228
Phone
(318) 675-6081
Fax
(318) 675-6059
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X L6693 TX
Pediatric Infectious Diseases Physician 2080P0208X MD023912 LA Primary

Addresses

Primary practice location

1501 Kings Hwy # 5-303
Shreveport, LA 71103-4228

Mailing address

1501 Kings Hwy # 5-303
Shreveport, LA 71103-4228
Phone (318) 675-6081

Other identifiers 2

IdentifierTypeStateIssuer
158010201MedicaidTX
1014559MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070717000457 LA Practitioner - Pediatric Medicine 0749380996 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD023912LAMDPediatric Infectious Diseases Physician
L6693TXMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University Health Sciences Center CurrentSince Feb 8, 2016 Accepting new patients
Louisiana State University Health Sciences Center Shreveport CurrentSince Feb 8, 2016 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Dec 1, 2016 Accepting new patients

Locations

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1501 Kings Hwy
#5303
Shreveport, LA 71103
Phone (318) 675-6081

Interoperability endpoints

  • Direct secure messaging: jvanchiere727973@direct.ochsner.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1871673111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY # 5-303",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-6081",
            "fax_number": "318-675-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY # 5-303",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-6081",
            "fax_number": "318-675-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCHIERE",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD/PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "TX",
            "license": "L6693",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "LA",
            "license": "MD023912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158010201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014559",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.