Individual provider Active NPI

Roy Vance Markham, M.D.

  • Cardiovascular Disease Physician
  • Bossier City, LA
National Provider Identifier
1922098532
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD.05815R Issued in LA
Practice address
2400 Hospital Dr
Suite 490
Bossier City, LA 71111-2385
Phone
(318) 798-9400
Fax
(318) 798-6785
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD.05815R LA Primary

Addresses

Primary practice location

2400 Hospital Dr
Suite 490
Bossier City, LA 71111-2385

Mailing address

PO Box 51008
Shreveport, LA 71135-1008
Phone (318) 798-9400

Other identifiers 4

IdentifierTypeStateIssuer
108411001MedicaidAR
060041371OtherLARAILROAD MEDICARE
107412201MedicaidTX
1323195MedicaidLA

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

LicenseStateTypeSpecialty
MD.05815RLAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ark-la-Tex Cardiology, Apmc Cardiovascular Disease PastSince Mar 1, 1991 Accepting new patients
Advanced Cardiovascular Specialists Cardiovascular Disease PastSince Jul 1, 2017 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1922098532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51008",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711351008",
            "telephone_number": "318-798-9400",
            "fax_number": "318-798-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HOSPITAL DR",
            "address_2": "SUITE 490",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112385",
            "telephone_number": "318-798-9400",
            "fax_number": "318-798-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKHAM",
        "first_name": "ROY",
        "middle_name": "VANCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "MD.05815R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108411001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060041371",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107412201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1323195",
            "state": "LA"
        }
    ],
    "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 Jul 8, 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.

Verify at the official NPI Registry.