Active NPI
WK River Cities Interventional Pain
- Pain Medicine (Anesthesiology) Physician
- Shreveport, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- 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
- Last updated
- Jun 8, 2012
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | Primary |
Addresses
Primary practice location
1811 E Bert Kouns Industrial Loop
Suite 300
Shreveport, LA 71105-5740
Mailing address
1811 E Bert Kouns Industrial Loop
Suite 300
Shreveport, LA 71105-5740
Phone (318) 212-3636
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba WK Renal Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Shreveport, LA
- NPI 1003020579
Member Of
Locations
1811 E Bert Kouns Industrial Loop
Ste 300
Shreveport, LA 71105
Phone (318) 212-3636
2403 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-8085
7925 Youree Dr
Ste 280B
Shreveport, LA 71105
Phone (318) 212-3636
Practitioners & affiliated clinicians
Practitioners 18
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.
-
- Physician Assistant
- Shreveport, LA
- NPI 1629552625
-
- Physician Assistant
- Shreveport, LA
- NPI 1336575778
-
- Physician Assistant
- Jefferson, LA
- NPI 1275187874
-
- Physician Assistant
- Shreveport, LA
- NPI 1730555616
-
- Medical Physician Assistant
- Bossier City, LA
- NPI 1609097070
Single Specialty
-
- Pain Medicine (Anesthesiology) Physician
- Bossier City, LA
- NPI 1841580776
-
- Physician Assistant
- Bossier City, LA
- NPI 1942672282
-
- Physician Assistant
- Bossier City, LA
- NPI 1669796926
-
- Medical Physician Assistant
- Bossier City, LA
- NPI 1457750366
-
- Physician Assistant
- Shreveport, LA
- NPI 1164732590
-
- Acute Care Nurse Practitioner
- Bossier City, LA
- NPI 1639406580
-
- Physician Assistant
- Shreveport, LA
- NPI 1619208790
NPI Registry JSON
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": [],
"endpoints": [],
"other_names": []
}
Other providers in Shreveport, LA
- WK Radiation Oncology Services
- WK Red River Cardiovascular Surgeons
- 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
Sources for this page
- 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.