Individual provider Active NPI

Travis Headley, MD

  • Emergency Medicine Physician
  • Shreveport, LA
National Provider Identifier
1982847414
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.204300 Issued in LA
Practice address
2034 Garrett Farms Row
Shreveport, LA 71106-2572
Phone
(304) 919-0530
NPI assigned
Apr 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.204300 LA Primary
Emergency Medicine Physician 207P00000X ME 112510 FL

Addresses

Primary practice location

2034 Garrett Farms Row
Shreveport, LA 71106-2572

Mailing address

2034 Garrett Farms Row
Shreveport, LA 71106-2572
Phone (304) 919-0530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130227000050 LA Practitioner - Emergency Medicine 3870740384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
West Virginia University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cross Lake Emergency Group, LLCGroup PAC ID 5395096440, 60 clinicians

Practice addresses (Care Compare)

2400 Hospital Dr
Bossier City, LA 71111-2385
Phone (318) 212-7000

Hospital & facility affiliations

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
ME 112510FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Lake Emergency Group, LLC Emergency Medicine CurrentSince Oct 1, 2018 Accepting new patients
Best Care Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Louisiana Em-1 Medical Services, PC Past 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

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 4

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": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1982847414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2034 GARRETT FARMS ROW",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711062572",
            "telephone_number": "304-919-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 GARRETT FARMS ROW",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711062572",
            "telephone_number": "304-919-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADLEY",
        "first_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-14",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.204300",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME 112510",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.