NPIMap

Individual provider Active NPI

Dakota Boston, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Shreveport, LA
National Provider Identifier
1962899971
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD.307727 Issued in LA
Practice address
1811 E Bert Kouns Industrial Loop Ste 480
Shreveport, LA 71105-5765
Phone
(318) 212-2810
Fax
(318) 212-2818
NPI assigned
Apr 17, 2015
Last updated
Jul 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X MD.307727 LA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD.307727 LA Primary

Addresses

Primary practice location

1811 E Bert Kouns Industrial Loop Ste 480
Shreveport, LA 71105-5765

Mailing address

2449 Hospital Dr Ste 400
Bossier City, LA 71111-1914
Phone (182) 127-9023

Other practice location 1

1501 Kings Hwy
Internal Medicine
Shreveport, LA 71103-4228
Phone (318) 813-2528

Other identifiers 1

IdentifierTypeStateIssuer
2387928MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180925002728 LA Practitioner - Internal Medicine 0345549531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
WK Endocrine SpecialistsGroup PAC ID 6406980689, 8 clinicians

Practice addresses (Care Compare)

2449 Hospital Dr
Suite 400
Bossier City, LA 71111-1914
Phone (318) 212-7902

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.307727LAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Endocrine Specialists Single Specialty CurrentSince Aug 1, 2022 Accepting new patients
WK Pierremont Endocrine Center Single Specialty CurrentSince Jul 17, 2022 Accepting new patients
Laura Kimball-Ravari MD and Willis-Knighton Medical Center Single Specialty PastSince Jul 17, 2022 Accepting new patients

Locations

2449 Hospital Dr
Ste 400
Bossier City, LA 71111
Phone (318) 212-7902

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

1811 E Bert Kouns Industrial Loop
Ste 480
Shreveport, LA 71105
Phone (318) 212-2810

Interoperability endpoints

  • Direct secure messaging: dboston@direct.wkhs.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1962899971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2449 HOSPITAL DR STE 400",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711111914",
            "telephone_number": "182-127-9023",
            "fax_number": "318-212-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 E BERT KOUNS INDUSTRIAL LOOP STE 480",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055765",
            "telephone_number": "318-212-2810",
            "fax_number": "318-212-2818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kings Hwy",
            "address_2": "Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-813-2528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "DAKOTA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-17",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.307727",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "LA",
            "license": "MD.307727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2387928",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.