DR. JODE JANN BURGIN (NPI# 1053541565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053541565 |
| Entity Type | Individual |
| Full Name | DR. JODE JANN BURGIN |
| Credential | M.D. |
| Practice Address |
9220 Ellerbe Rd Suite 700 Shreveport LA 71106-6739 |
| Mailing Address |
919 Hidden Rdg Irving TX 75038-3813 |
| Practice Telephone | 3186815282 |
| Practice Fax Number | 3186815284 |
| Mailing Telephone | 4692822711 |
| Mailing Fax Number | 4692820996 |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2017-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301095167 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2398521 | 05 |
| Street Address |
9220 ELLERBE RD SUITE 700 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-6739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861415093 | Joseph Malcolm Lattier Jr. | Dentist | 9220 Ellerbe Rd, Suite 100, Shreveport, LA 71106-6739 | 2006-07-26 |
| 1265661367 | Richard Andrew Simpson | Dentist | 9220 Ellerbe Rd, Suite 100, Shreveport, LA 71106-6739 | 2009-07-09 |
| 1174734818 | Gretchen G Petterway | Pediatrics | 9220 Ellerbe Rd, Suite 700, Shreveport, LA 71106-6739 | 2007-05-24 |
| 1992871040 | John E Stafford | Dentist | 9220 Ellerbe Rd, Suite 100, Shreveport, LA 71106 | 2006-11-28 |
| 1356411565 | Casey Harris Payne | Family Medicine | 9220 Ellerbe Rd, Ste 700, Shreveport, LA 71105-6709 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922621390 | Partners In Primary Care La PC | Family Medicine | 7551 Youree Dr Ste 11, Shreveport, LA 71105-5533 | 2020-05-20 |
| 1528609104 | Spectra Family Clinic, LLC | Family Medicine | 9300 Mansfield Rd Ste 209, Shreveport, LA 71118-3138 | 2019-10-04 |
| 1922502327 | Courtney Morgan | Family Medicine | 723 Milam St, Shreveport, LA 71101-3507 | 2018-03-20 |
| 1174973317 | Patrick Michael Fitz-gerald | Family Medicine | 731 Coachlight Rd, Shreveport, LA 71106-7205 | 2016-06-19 |
| 1437446341 | Samreena N Sara | Family Medicine | 8835 Line Ave Ste 400a, Shreveport, LA 71106-6722 | 2011-06-30 |
| 1932490554 | Michael Thomas Kitchell | Family Medicine | 1666 E Bert Koun Loop Ste 105, Shreveport, LA 71105-5718 | 2011-04-30 |
| 1831402254 | David J. Colvin Md LLC | Family Medicine | 148 Waters Edge Dr, Shreveport, LA 71106-7774 | 2010-07-15 |
| 1952628802 | Tri Pham | Family Medicine | 133 Charles Ave, Shreveport, LA 71105-3719 | 2010-04-30 |
| 1669799524 | Stephanie James | Family Medicine | 2120 Bert Kouns Industrial Loop Ste M, Shreveport, LA 71118-3355 | 2010-04-30 |
| 1205062965 | Charles Henry Nash | Family Medicine | 5935 Gilbert Dr, Shreveport, LA 71106-2315 | 2009-06-08 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.