Southern Oaks Properties, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

93 Issued in LA

Legal business name

SOUTHERN OAKS PROPERTIES, LLC

Practice address

1524 Glen Oak PL
Shreveport, LA 71103-3816

Phone

(318) 221-0911

Fax

(318) 222-6333

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Teddy Ray Price

Title

Managing Member

Phone

(318) 628-4116

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SOUTHERN OAKS NURSING & REHABILITATION CENTER Doing business as

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952469751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 GLEN OAK PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033816",
            "telephone_number": "318-221-0911",
            "fax_number": "318-222-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 GLEN OAK PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033816",
            "telephone_number": "318-221-0911",
            "fax_number": "318-222-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OAKS PROPERTIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "TEDDY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "318-628-4116"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "93",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510394",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN OAKS NURSING & REHABILITATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Southern Root Dentistry LLC
• James Wesley Southern

• All providers in Shreveport, LA
• Skilled Nursing Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.