Susan Elizabeth Kemp, MD
Individual provider Active NPI Internal Medicine Physician · Shreveport, LA
NPI 1972586527 · NPPES record last updated Jan 16, 2017
Key facts
- NPI
- 1972586527
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 024797 (LA)
- Practice address
- 1460 E Bert Kouns Industrial Loop
Suite 700
Shreveport, LA 71105-5644 - Phone
- (318) 681-5580
- Fax
- (318) 681-5280
- NPI assigned
- Nov 28, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 3
Owned or controlled facilities with NPI records 6
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Louisiana State University School of Medicine in Shreveport, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Christus Trinity Clinic Texas
Cornerstone Therapy and Balance Center, LLC
Practice addresses (Care Compare)
1549 E 70TH St
300 Christus Pedi Associates Shreveport
Shreveport, LA 71105-5056
Phone (318) 681-4896
8961 Youree Dr
Shreveport, LA 71115-3001
Phone (318) 671-8772
Hospital & facility affiliations
- Christus Homecare Shreveport-Bossier
- Centerwell Home Health
- Christus Shreveport-Bossier Health System
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 58 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
| Christus Trinity Clinic |
Rural health clinic | Corporate Director | Jan 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060829000292 | LA | Practitioner - Internal Medicine | 2668476995 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024797 | LA | MD | Internal Medicine Physician |
| L4487 | TX | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C H Wilkinson Physician Network | Current |
Accepting new patients | |
| Christus Trinity Clinic Texas | Internal Medicine | Current |
Accepting new patients |
| Christus Trinity Clinic Texas | Current |
Accepting new patients | |
| C H Wilkinson Physician Network | Internal Medicine | Current |
Accepting new patients |
| Marshall Health Services Inc | Internal Medicine | Past |
Accepting new patients |
Locations
1549 E 70th St
Ste 300
Shreveport, LA 71105
Phone (318) 300-3898
1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500
1801 Fairfield Ave
Ste 304
Shreveport, LA 71101
Phone (318) 212-0412
1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138
1460 E Bert Kouns Industrial Loop
Ste 700
Shreveport, LA 71105
Phone (318) 424-3291
919 Hidden Rdg
Irving, TX 75038
703 E Marshall Ave
Ste 5008
Longview, TX 75601
Phone (903) 315-4800
700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000
Interoperability endpoints
- skemp208313@christushealth.direct-ci.net
- https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | L4487 | TX | |
| Internal Medicine Physician | 207R00000X | 024797 | LA | Yes |
Addresses
Primary practice location
1460 E Bert Kouns Industrial Loop
Suite 700
Shreveport, LA 71105-5644
Mailing address
919 Hidden RDG
Irving, TX 75038-3813
Phone (469) 282-2711
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 152646901 | Medicaid | TX | |
| 1578398 | Medicaid | LA |
Other providers in Shreveport, LA
- Tamara Yvette Kelly
- Zona C Kelly
- Zondrian Kelly
- Ryan Kelm
- Cassandra Anne Kemmerer
- Candace Capelan Kemper
- Ken Stanley MD and Willis-Knighton Medical Center
- Jazzelyn Kendrick
- Terry Wayne Kendrick
- Aliyah Kennedy
All providers in Shreveport, LA · Internal Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.