Shreveport Endoscopy Center, a Medical Corporation

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

50 Issued in LA

Legal business name

SHREVEPORT ENDOSCOPY CENTER, A MEDICAL CORPORATION

Practice address

3217 Mabel St
Shreveport, LA 71103-4022

Phone

(318) 631-0072

Fax

(318) 213-4979

NPI assigned

Feb 6, 2006

Organization subpart

No

Name

Dr. Sathya Jaganmohan, M.D.NPI 1922202597

Title

President

Phone

(318) 631-0072

Organizations this organization is a member of, according to the National Provider Directory.

• Gastrointestinal Specialists, a.M.C.

  • Gastroenterology Physician
  • Shreveport, LA
  • NPI 1932171725

  Member Of

  NPD member

Organizations listed as members of this organization in the National Provider Directory.

• Gastrointestinal Specialists, a.M.C.

  • Gastroenterology Physician
  • Shreveport, LA
  • NPI 1932171725

  Member Of

  NPD member

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sathya Jaganmohan, M.D.

  • Gastroenterology Physician
  • Shreveport, LA
  • NPI 1922202597
  NPD (past) Authorized official
• Humberto I Aguilar, M.D.

  • Gastroenterology Physician
  • Shreveport, LA
  • NPI 1366432577
  NPD
• Douglas E Rimmer Jr., M.D.

  • Gastroenterology Physician
  • Bossier City, LA
  • NPI 1386634590
  NPD
• John N Bienvenu, MD

  • Gastroenterology Physician
  • Bossier City, LA
  • NPI 1821265281
  NPD (past)
• Daryl Quintin Buckelew, M.D.

  • Gastroenterology Physician
  • Shreveport, LA
  • NPI 1588600662
  NPD (past)
• David F Dies, M.D

  • Transplant Hepatology Physician
  • Shreveport, LA
  • NPI 1205826419
  NPD (past)
• James C Hobley, M.D.

  • Gastroenterology Physician
  • Shreveport, LA
  • NPI 1336114917
  NPD (past)
• Lawrence W Johnson, M.D.

  • Gastroenterology Physician
  • Bossier City, LA
  • NPI 1619968641
  NPD (past)
• John A Kirkikis, MD

  • Gastroenterology Physician
  • Shreveport, LA
  • NPI 1700869724
  NPD (past)
• Nicolas T Labarre, MD

  • Gastroenterology Physician
  • Shreveport, LA
  • NPI 1881007540
  NPD (past)
• Catherine D. Linzay, MD

  • Gastroenterology Physician
  • Shreveport, LA
  • NPI 1619364247
  NPD (past)
• David M Philips, M.D.

  • Gastroenterology Physician
  • Shreveport, LA
  • NPI 1326038530
  NPD (past)

Listed as

Shreveport Endoscopy CenterCCN 19C0001042

Medicare certification status

ActiveFrom the Provider of Services file

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 12, 2022.

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1982676771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 MABEL ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034022",
            "telephone_number": "318-631-0072",
            "fax_number": "318-213-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 MABEL ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034022",
            "telephone_number": "318-631-0072",
            "fax_number": "318-213-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHREVEPORT ENDOSCOPY CENTER, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "JAGANMOHAN",
        "authorized_official_first_name": "SATHYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-631-0072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "LA",
            "license": "50",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "50",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1910678",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Shreveport, LA
• Endoscopy Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.