Individual provider Active NPI

Paul Bracey, M.D.

  • Emergency Medicine Physician
  • Shreveport, LA
National Provider Identifier
1992738629
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
17686 Issued in MS
Practice address
6841 Fern Avenue
Suite 100
Shreveport, LA 71105
Phone
(318) 868-2273
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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.025069 LA
Emergency Medicine Physician 207P00000X 17686 MS Primary

Addresses

Primary practice location

6841 Fern Avenue
Suite 100
Shreveport, LA 71105

Mailing address

PO Box 5789
Shreveport, LA 71135-5789

Other practice location 1

1221 S Clearview Pkwy
Jefferson, LA 70121-1011
Phone (504) 842-4025

Other identifiers 1

IdentifierTypeStateIssuer
05286360MedicaidMS

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
I20110207000306 LA Practitioner - Emergency Medicine 9436125762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1641 E 70TH St
300 Olhs Urgent Care Shreveport
Shreveport, LA 71105-5118
Phone (318) 626-0037

Hospital & facility affiliations

  • Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.025069LAMDEmergency Medicine Physician
17686MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince May 17, 2021 Accepting new patients
Ochsner Clinic LLC CurrentSince May 17, 2021 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Louisiana Em-1 Medical Services, PC Past Accepting new patients
St. Dominic Jackson Memorial Emergency Medicine Past Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients

Locations

10310 The Grove Blvd
Baton Rouge, LA 70836
Phone (225) 761-5239

2113 Airline Dr
Ste 100
Bossier City, LA 71111
Phone (318) 519-3088

1000 Ochsner Blvd
Covington, LA 70433
Phone (985) 898-7051

1221 S Clearview Pkwy
New Orleans, LA 70121
Phone (504) 736-4600

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

6841 Fern Ave
Ste 100
Shreveport, LA 71105
Phone (318) 626-4200

1641 E 70th St
Ste 300
Shreveport, LA 71105
Phone (318) 626-0037

Organizations & group practices 7

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 1

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1992738629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5789",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711355789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6841 FERN AVENUE",
            "address_2": "SUITE 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-868-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 S Clearview Pkwy",
            "address_purpose": "LOCATION",
            "city": "Jefferson",
            "state": "LA",
            "postal_code": "701211011",
            "country_code": "US",
            "telephone_number": "504-842-4025",
            "fax_number": "504-842-7756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRACEY",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.025069",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "17686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05286360",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.