Active NPI
Leo Ennis Fleniken III, PD
- Pharmacist
- Bossier City, LA
National Provider Identifier
1912393042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9549
- Practice address
- 3045 E Texas St
Bossier City, LA 71111-3207 - Phone
- (318) 741-1776
- NPI assigned
- Apr 15, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9549 | LA | Primary |
Addresses
Primary practice location
3045 E Texas St
Bossier City, LA 71111-3207
Mailing address
529 Stratmore Dr
Shreveport, LA 71115-3019
Phone (318) 455-8255
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9549 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429056000000",
"number": "1912393042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "529 STRATMORE DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711153019",
"telephone_number": "318-455-8255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3045 E TEXAS ST",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711113207",
"telephone_number": "318-741-1776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLENIKEN",
"first_name": "LEO",
"middle_name": "ENNIS",
"name_suffix": "III",
"credential": "PD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-15",
"last_updated": "2015-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "9549",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bossier City, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.