WK Advanced Urology

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

WK ADVANCED UROLOGY

Practice address

2300 Hospital Dr Ste 460
Bossier City, LA 71111-2166

Phone

(318) 212-7335

Fax

(318) 212-7336

NPI assigned

Feb 22, 2021

Organization subpart

No

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

Authorized official

Name

Mary Jane Ward

Title

Sr VP of Finance

Phone

(318) 212-7335

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Willis Knighton Medical Center, Inc.

  dba WK Renal Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Shreveport, LA
  • NPI 1003020579

  Member Of

  NPD member

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gerard Dayle Henry, M.D.

  • Urology Physician
  • Bossier City, LA
  • NPI 1508862905
  Medicare reassignment Care Compare group NPD
• Allison Liddle, PA-C

  • Physician Assistant
  • Bossier City, LA
  • NPI 1659230852
  Medicare reassignment Care Compare group NPD
• Brandon Scott O'Quinn, FNP

  • Family Nurse Practitioner
  • Livingston, LA
  • NPI 1295214096
  Medicare reassignment Care Compare group NPD
• Joyce Elizabeth Feagin, MD

  • Hematology & Oncology Physician
  • Shreveport, LA
  • NPI 1285660316
  NPD (past)
• Maxwell C McDonald III, MD

  • Hematology & Oncology Physician
  • Shreveport, LA
  • NPI 1699764589
  NPD (past)

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1922692813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR STE 460",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112166",
            "telephone_number": "318-212-7335",
            "fax_number": "318-212-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR STE 460",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112166",
            "telephone_number": "318-212-7335",
            "fax_number": "318-212-7336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8001 Youree Dr Ste 500",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711152341",
            "country_code": "US",
            "telephone_number": "318-212-7335",
            "fax_number": "318-212-7336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WK ADVANCED UROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "SR VP OF FINANCE",
        "authorized_official_telephone_number": "318-212-7335"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winn Community Health Center, Inc. (Bossier Community Health Center Pharmacy)
• Winn Community Health Center, Inc. (Bossier Community Health Center)
• Lauryn Winn
• Jacqueline Yvette Winston
• James Allen Wiseman, D.C.
• WK Allergy and Asthma Clinic
• WK and Bone & Joint Clinic - Bossier
• WK and the Asthma-Allergy Clinic
• WK Arklatex Urology and Prostate Cancer Institute
• WK Behavioral Health Medical Center

• Urology Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Urology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.