Individual provider Active NPI

Michael Clarke Pearson, MD

  • Emergency Medicine Physician
  • Shreveport, LA
National Provider Identifier
1962768747
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD208148 Issued in LA
Practice address
8001 Youree Dr
Shreveport, LA 71115-2302
Phone
(318) 212-3000
NPI assigned
Apr 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD208148 LA Primary

Addresses

Primary practice location

8001 Youree Dr
Shreveport, LA 71115-2302

Mailing address

8001 Youree Dr
Shreveport, LA 71115-2302
Phone (318) 212-3000

Other names 1

  • Michael Francis Clarke-Pearson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150915001159 LA Practitioner - Emergency Medicine 6204064785 Reassigns benefits to 1 organization
I20200610001717 NC Practitioner - Emergency Medicine 6204064785 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians

Practice addresses (Care Compare)

2400 W Friendly Ave
Greensboro, NC 27403-1109
Phone (336) 716-2255

Hospital & facility affiliations

  • Watauga Medical Center Hospital, Boone, NC, CCN 340051
  • Charles a Cannon Jr Memorial Hospital Hospital, Linville, NC, CCN 341323

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD208148LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Lake Emergency Group, LLC Emergency Medicine CurrentSince Oct 4, 2018 Accepting new patients
Wake Forest Emergency Providers CurrentSince Jul 1, 2020 Accepting new patients
Jefferson Emergency Services, PLLC Emergency Medicine CurrentSince Oct 15, 2020 Accepting new patients

Locations

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

2510 Bert Kouns Industrial Loop
Shreveport, LA 71118
Phone (318) 212-5000

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

200 Hospital Ave
Jefferson, NC 28640
Phone (336) 246-7101

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: mpearson1013792@direct.unc.nchie.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468368000000",
    "number": "1962768747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-212-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-212-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "MICHAEL",
        "middle_name": "CLARKE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD208148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "CLARKE-PEARSON",
            "middle_name": "FRANCIS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.