Individual provider Active NPI

Giao N DO, M.D.

  • Pediatric Critical Care Medicine Physician
  • Shreveport, LA
National Provider Identifier
1992792535
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
06500R Issued in LA
Practice address
2510 Bert Koun Loop RM 4003
Shreveport, LA 71118-3119
Phone
(318) 212-5665
Fax
(318) 212-5698
NPI assigned
Sep 29, 2005
Last updated
Jun 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 06500R LA Primary

Addresses

Primary practice location

2510 Bert Koun Loop RM 4003
Shreveport, LA 71118-3119

Mailing address

2510 Bert Koun Loop RM 4003
Shreveport, LA 71118-3119
Phone (318) 212-5665

Other identifiers 2

IdentifierTypeStateIssuer
1360007MedicaidLA
X9W961282MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06500RLAMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WK Pediatric Intensivist Pediatric Critical Care Medicine CurrentSince Feb 9, 2018 Accepting new patients

Locations

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

2510 Bert Kouns Industrial Loop
Rm 4003
Shreveport, LA 71118
Phone (318) 212-5665

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1992792535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 BERT KOUN LOOP RM 4003",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183119",
            "telephone_number": "318-212-5665",
            "fax_number": "318-212-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 BERT KOUN LOOP RM 4003",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183119",
            "telephone_number": "318-212-5665",
            "fax_number": "318-212-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "GIAO",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "LA",
            "license": "06500R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1360007",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "X9W961282",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.