Progressive Childrens Clinic LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PROGRESSIVE CHILDRENS CLINIC LLC

Practice address

1919 Fairfield Ave
Shreveport, LA 71101

Phone

(318) 828-2210

Fax

(318) 828-2215

NPI assigned

Feb 13, 2012

Organization subpart

No

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

Authorized official

Name

Amanda Kampert, M.DNPI 1699769026

Title

Owner

Phone

(318) 828-2210

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Lynn Kampert, MD

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1699769026
  NPD (past) Authorized official
• Derek R. Harris, MSN, APRN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Shreveport, LA
  • NPI 1821360728
  NPD (past)
• Ashley C Viviano, MSN, APRN, PNP-PC

  • Pediatric Nurse Practitioner
  • Shreveport, LA
  • NPI 1447810973
  NPD (past)

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561680000000",
    "number": "1942573589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 FAIRFIELD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71101",
            "telephone_number": "318-828-2210",
            "fax_number": "318-828-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 FAIRFIELD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71101",
            "telephone_number": "318-828-2210",
            "fax_number": "318-828-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE CHILDRENS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-13",
        "last_updated": "2019-06-28",
        "status": "A",
        "authorized_official_last_name": "KAMPERT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-828-2210",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2195719",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PRN Health Services, PC
• Paul Forrest Procell, OT
• Carlie Proctor
• Lanita Proctor
• Professional Sitter Services
• Promas LLC
• Promise Behavioral Health Hospital of Shreveport, Inc.
• Promise Hospital of Louisiana, Inc
• Promoting Livelihood and Ability in Youth Physical Therapy LLC
• Promyse-Prosthetic Orthotic Group

• Pediatrics Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.