WK Shreveport Infectious Disease

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

WK SHREVEPORT INFECTIOUS DISEASE

Practice address

8001 Youree Dr
Suite 750
Shreveport, LA 71115-2302

Phone

(318) 212-3939

Fax

(318) 212-3965

NPI assigned

Mar 12, 2009

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) 212-4232

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

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

Locations

Practitioners 3

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

• Hector Brunet Rodriguez, MD

  • Infectious Disease Physician
  • Shreveport, LA
  • NPI 1104075290
  Medicare reassignment Care Compare group NPD
• Gerardo Negron, MD

  • Infectious Disease Physician
  • Shreveport, LA
  • NPI 1396795795
  Medicare reassignment Care Compare group
• Guillermo Orlando Padilla, M.D.

  • Infectious Disease Physician
  • Shreveport, LA
  • NPI 1124229265
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1992946404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "address_2": "SUITE 750",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-212-3939",
            "fax_number": "318-212-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "address_2": "SUITE 750",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-212-3939",
            "fax_number": "318-212-3965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK SHREVEPORT INFECTIOUS DISEASE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-12",
        "last_updated": "2012-06-08",
        "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": "318-212-4232"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1792969",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WK River Cities Interventional Pain
• WK Robotic and Laparoscopic Surgery Clinic
• WK Shreveport Behavioral Wellness Center
• WK Shreveport Breast Center
• WK Shreveport Center for Geriatric Health
• WK Shreveport Internal Medicine
• WK Shreveport Sleep Medicine
• WK Signature Urology Clinic
• WK South Audiology Center
• WK South Hospitalists

• Infectious Disease Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Infectious Disease Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.