JOHN KEVIN NETTERVILLE (NPI# 1225084536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225084536 |
| Entity Type | Individual |
| Full Name | JOHN KEVIN NETTERVILLE |
| Credential | MD |
| Practice Address |
One St Mary Place Shreveport LA 71101 |
| Mailing Address |
10326 Goldsberry Shreveport LA 71106 |
| Practice Telephone | 3186814500 |
| Practice Fax Number | 3186814177 |
| Mailing Telephone | 3187980998 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 12640R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1541800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790905974 | John T Netterville Jr. | Pediatrics | The Attention & Behavior Clinic, 2001 Mallory Lane Ste 300, Franklin, TN 37067-8236 | 2007-04-27 |
| Street Address |
ONE ST MARY PLACE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548200587 | Kevin Charles Huston | Emergency Medicine | One St Mary Place, Shreveport, LA 71101 | 2006-06-07 |
| 1700825221 | Arthur M Brister | Emergency Medicine | One St Mary Place, Shreveport, LA 71101 | 2006-06-06 |
| 1578502076 | James Walton Nichols | Emergency Medicine | One St Mary Place, Shreveport, LA 71101 | 2006-06-06 |
| 1548209059 | Christus Health Northern Louisiana | Emergency Medicine | One St Mary Place, Shreveport, LA 71101 | 2006-06-06 |
| 1174570998 | Thomas Brian Caskey | Internal Medicine | One St Mary Place, Shreveport, LA 71101 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982871182 | Edward Locascio | Emergency Medicine | 1512 W Kirby Place, Department of Emergency Medicine, Shreveport, LA 71103-3822 | 2008-05-15 |
| 1780722686 | Joseph Salvador Bianca | Emergency Medicine | 715 Chinquapin Dr, Shreveport, LA 71106-7200 | 2007-02-02 |
| 1902950363 | Richard A Aycock II | Emergency Medicine | 2510 Bert Kouns Indistrial Loop, Shreveport, LA 71118 | 2007-01-23 |
| 1962555342 | Charles Leonard Black | Emergency Medicine | 7600 General Motors Blvd, Medical Department, Shreveport, LA 71129-9426 | 2007-01-19 |
| 1801820121 | Mary Ann Edens | Emergency Medicine | 1501 King's Highway, Shreveport, LA 71103 | 2006-07-10 |
| 1992738629 | Paul Bracey | Emergency Medicine | 6841 Fern Avenue, Suite 100, Shreveport, LA 71105 | 2006-07-08 |
| 1306875570 | Edward Ronald Samper | Emergency Medicine | 1666 E Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71105-5714 | 2006-07-01 |
| 1366482309 | Kenneth David Miller | Emergency Medicine | 11165 Heritage Oaks, Shreveport, LA 71106-8383 | 2006-06-07 |
| 1245206077 | Jerel L Raney | Emergency Medicine | 7045 Youree Dr, Shreveport, LA 71105-5108 | 2006-02-23 |
| 1609867415 | Magdy Eskander | Emergency Medicine | 2724 Greenwood Rd, Shreveport, LA 71109-4635 | 2005-11-01 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
Please comment or provide details below to improve the information on JOHN KEVIN NETTERVILLE.
| 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.