WK River Cities Interventional Pain

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

WK RIVER CITIES INTERVENTIONAL PAIN

Practice address

1811 E Bert Kouns Industrial Loop
Suite 300
Shreveport, LA 71105-5740

Phone

(318) 212-3636

Fax

(318) 212-3649

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

Greg J. Gavin

Title

Network Administrator

Phone

(318) 212-8085

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

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

• Willis Knighton Medical Center, Inc.

  • Skilled Nursing Facility
  • Shreveport, LA
  • NPI 1144267451

  Member Of

  NPD member

Locations

Practitioners 18

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

• Kelsey Austin Ellender-Barthel, PA

  • Physician Assistant
  • Shreveport, LA
  • NPI 1629552625
  NPD
• Sarah Carson Brantley, P.A.

  • Physician Assistant
  • Shreveport, LA
  • NPI 1336575778
  NPD (past)
• Tyra Brown, PA-C

  • Physician Assistant
  • Jefferson, LA
  • NPI 1275187874
  NPD (past)
• Hillary Davis, PA

  • Physician Assistant
  • Shreveport, LA
  • NPI 1730555616
  NPD (past)
• Elizabeth Michelle Doolittle, PA-C

  • Medical Physician Assistant
  • Bossier City, LA
  • NPI 1609097070

  Single Specialty

  NPD (past)
• David Elkind Hirsch

  • Pain Medicine (Anesthesiology) Physician
  • Bossier City, LA
  • NPI 1841580776

  Pain Medicine

  NPD (past)
• Paige Hewlett Jackson, PA-C

  • Physician Assistant
  • Bossier City, LA
  • NPI 1942672282
  NPD (past)
• Kristy A Kehoe, PA

  • Physician Assistant
  • Bossier City, LA
  • NPI 1669796926
  NPD (past)
• Emily K. Leblanc, PA

  • Medical Physician Assistant
  • Bossier City, LA
  • NPI 1457750366
  NPD (past)
• Stephanie Hunt Ledoux, PA

  • Physician Assistant
  • Shreveport, LA
  • NPI 1164732590
  NPD (past)
• Erin Elizabeth Richard, NP

  • Acute Care Nurse Practitioner
  • Bossier City, LA
  • NPI 1639406580
  NPD (past)
• Carmen R. Schaumburg, PA-C

  • Physician Assistant
  • Shreveport, LA
  • NPI 1619208790
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1962447052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "SUITE 300",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055740",
            "telephone_number": "318-212-3636",
            "fax_number": "318-212-3649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "SUITE 300",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055740",
            "telephone_number": "318-212-3636",
            "fax_number": "318-212-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK RIVER CITIES INTERVENTIONAL PAIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2012-06-08",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "NETWORK ADMINISTRATOR",
        "authorized_official_telephone_number": "318-212-8085"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1448222",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WK Radiation Oncology Services
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• WK Regional Perinatal Group
• WK Regional Transplant Center
• WK Rheumatology Pierremont
• WK Robotic and Laparoscopic Surgery Clinic
• WK Shreveport Behavioral Wellness Center
• WK Shreveport Breast Center
• WK Shreveport Center for Geriatric Health
• WK Shreveport Infectious Disease

• All providers in Shreveport, LA
• Pain Medicine (Anesthesiology) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.