WK Shreveport Sleep Medicine

Primary specialty

Sleep Medicine (Family Medicine) PhysicianTaxonomy code 207QS1201X

Legal business name

WK SHREVEPORT SLEEP MEDICINE

Practice address

1666 E Bert Koun Loop
Suite 230
Shreveport, LA 71105-5714

Phone

(318) 212-8780

Fax

(318) 212-6752

NPI assigned

Mar 21, 2017

Organization subpart

No

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

Authorized official

Name

Greg J Gavin

Title

Network Administrator

Phone

(318) 212-8780

Specialties & licenses 1

Addresses

Member of 1

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

• Willis Knighton Medical Center, Inc.

  • Skilled Nursing Facility
  • Shreveport, LA
  • NPI 1144267451

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1992236152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 E BERT KOUN LOOP",
            "address_2": "SUITE 230",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055714",
            "telephone_number": "318-212-8780",
            "fax_number": "318-212-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 E BERT KOUN LOOP",
            "address_2": "SUITE 230",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055714",
            "telephone_number": "318-212-8780",
            "fax_number": "318-212-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK SHREVEPORT SLEEP MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NETWORK ADMINISTRATOR",
        "authorized_official_telephone_number": "318-212-8780"
    },
    "taxonomies": [
        {
            "code": "207QS1201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WK Shreveport Behavioral Wellness Center
• WK Shreveport Breast Center
• WK Shreveport Center for Geriatric Health
• WK Shreveport Infectious Disease
• WK Shreveport Internal Medicine
• WK Signature Urology Clinic
• WK South Audiology Center
• WK South Hospitalists
• WK South OB-GYN Clinic
• WK South Orthopedic Clinic

• Sleep Medicine (Family Medicine) Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Sleep Medicine (Family Medicine) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.