NPIMap

Individual provider Active NPI

Susan Elizabeth Kemp, MD

  • Internal Medicine Physician
  • Shreveport, LA
National Provider Identifier
1972586527
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
024797 Issued in 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
Last updated
Jan 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L4487 TX
Internal Medicine Physician 207R00000X 024797 LA Primary

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

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
I20060829000292 LA Practitioner - Internal Medicine 2668476995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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 TexasGroup PAC ID 3072426741, 1,540 clinicians
Cornerstone Therapy and Balance Center, LLCGroup PAC ID 0345397899, 98 clinicians

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024797LAMDInternal Medicine Physician
L4487TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Dec 1, 2020 Accepting new patients
C H Wilkinson Physician Network Internal Medicine CurrentSince Feb 1, 2011 Accepting new patients
C H Wilkinson Physician Network CurrentSince Feb 1, 2011 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
Marshall Health Services Inc Internal Medicine PastSince Sep 1, 2009 Accepting new patients

Locations

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

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

1549 E 70th St
Ste 300
Shreveport, LA 71105
Phone (318) 300-3898

1801 Fairfield Ave
Ste 304
Shreveport, LA 71101
Phone (318) 212-0412

919 Hidden Rdg
Irving, TX 75038

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

703 E Marshall Ave
Ste 5008
Longview, TX 75601
Phone (903) 315-4800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: skemp208313@christushealth.direct-ci.net

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Christus Trinity ClinicHawkins, TX, CCN 673886 Rural health clinic Corporate Director Jan 1, 2022
Christus Trinity ClinicQuitman, TX, CCN 673823 Rural health clinic Corporate Director Jan 1, 2022
Christus Trinity ClinicMineola, TX, CCN 673825 Rural health clinic Corporate Director Jan 1, 2022
Christus Trinity ClinicCanton, TX, CCN 673822 Rural health clinic Corporate Director Jan 1, 2022
Christus Trinity ClinicEmory, TX, CCN 673811 Rural health clinic Corporate Director Jan 1, 2022
Christus Trinity ClinicWinnsboro, TX, CCN 678958 Rural health clinic Corporate Director Jan 1, 2022

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1972586527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 HIDDEN RDG",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383813",
            "telephone_number": "469-282-2711",
            "fax_number": "469-282-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 E BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "SUITE 700",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055644",
            "telephone_number": "318-681-5580",
            "fax_number": "318-681-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L4487",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "024797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.