SHANNON KOVELESKIE (NPI# 1225417942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225417942 |
| Entity Type | Individual |
| Full Name | SHANNON KOVELESKIE |
| Practice Address |
1860 Fairfield Ave Shreveport LA 71101-4431 |
| Practice Telephone | 3186751313 |
| Practice Fax Number | 3186751319 |
| Mailing Telephone | 3186751313 |
| Mailing Fax Number | 3186751319 |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2015-05-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA.200784 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1860 FAIRFIELD AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689623548 | Neil L Halim | Family Medicine | 1860 Fairfield Ave, Shreveport, LA 71101-4431 | 2006-05-09 |
| 1659807980 | Megan Ray O'neal | Nurse Practitioner | 1860 Fairfield Ave, Shreveport, LA 71101-4431 | 2017-05-05 |
| 1275075129 | Neil Halim Fairfield Family Clinic | Clinic/Center | 1860 Fairfield Ave, Shreveport, LA 71101-4431 | 2016-11-09 |
| 1457704306 | Kasey Lattier | Nurse Practitioner | 1860 Fairfield Ave, Shreveport, LA 71101-4431 | 2016-07-15 |
| 1437408846 | Cheryl Wiley Adair | Family Medicine | 1860 Fairfield Ave, Shreveport, LA 71101-4431 | 2012-08-30 |
| 1669796926 | Kristy Addison Kehoe | Physician Assistant | 1860 Fairfield Ave, Shreveport, LA 71101 | 2010-03-16 |
| 1104025121 | Neil Halim Fairfield Family Clinic | Family Medicine | 1860 Fairfield Ave, Shreveport, LA 71101-4431 | 2007-07-11 |
| 1760418131 | Nancy Clearkin Germany | Family Medicine | 1860 Fairfield Ave, Shreveport, LA 71101-4431 | 2006-06-25 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740829217 | Bno Surgical Consultants, LLC | Physician Assistant | 303 Captain Hm Shreve Blvd, Shreveport, LA 71115 | 2020-01-02 |
| 1497394076 | Midday Surgical Consultants, LLC | Physician Assistant | 550 Linden St, Shreveport, LA 71104-4426 | 2019-12-31 |
| 1225677800 | Geaux Surgical Consultants, LLC | Physician Assistant | 370 Gallier Pl, Shreveport, LA 71106-8377 | 2019-12-31 |
| 1962041541 | Ace Surgical Consultants, LLC | Physician Assistant | 11045 Gabriels Path, Shreveport, LA 71106-7791 | 2019-12-31 |
| 1013499763 | Kristi Harrison Gaspard | Physician Assistant | 2508 Bert Koun Loop Ste 106, Shreveport, LA 71118-3175 | 2018-08-29 |
| 1295216125 | Heather White | Physician Assistant | 745 Olive St Ste 200, Shreveport, LA 71104-2246 | 2018-08-28 |
| 1285143669 | Kara Forbis | Physician Assistant | 2600 Kings Hwy Ste 420, Shreveport, LA 71103-3950 | 2017-09-28 |
| 1144748195 | Catherine Murphy Rogers | Physician Assistant | 2727 Hearne Ave Ste 300, Shreveport, LA 71103-3918 | 2017-08-30 |
| 1972955474 | Robin Egan | Physician Assistant | 1811 E Bert Koun Loop Ste 200, Shreveport, LA 71105-5766 | 2016-07-07 |
| 1457733198 | Brfhh Shreveport LLC | Physician Assistant | 1541 Kings Highway, Shreveport, LA 71103-4228 | 2015-06-18 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
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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.