WK NORTH ORTHOPEDIC CLINIC (NPI# 1306823596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306823596 |
Entity Type | Organization |
Organization Name | WK NORTH ORTHOPEDIC CLINIC |
Practice Address |
2751 Albert L Bicknell Dr Suite 1-b Shreveport LA 71103-3920 |
Mailing Address |
1202 Louisiana Ave Shreveport LA 71101-3910 |
Practice Telephone | 3182128776 |
Practice Fax Number | 3182128774 |
Mailing Telephone | 3182128776 |
Mailing Fax Number | 3182128774 |
Enumeration Date | 2005-12-28 |
Last Update Date | 2012-06-08 |
Authorized Official Name | GREG J GAVIN (NETWORK ADMINISTRATOR) |
Authorized Official Telephone | 3182124232 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
LA | 1447838 | 05 |
Street Address |
2751 ALBERT L BICKNELL DR SUITE 1-B |
City | SHREVEPORT |
State | LA |
Zip Code | 71103-3920 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104374099 | Britney Brown | Physician Assistant | 2751 Albert L Bicknell Dr, Suite 5c, Shreveport, LA 71103-3920 | 2016-09-20 |
1831566777 | Summer Leigh Robin | Nurse Practitioner | 2751 Albert L Bicknell Dr, Shreveport, LA 71103-3920 | 2015-08-26 |
1740665694 | Jennifer Michelle Bigbee | Physician Assistant | 2751 Albert L Bicknell Dr, Shreveport, LA 71103-3920 | 2015-07-21 |
1235511981 | Chase C White | Nurse Practitioner | 2751 Albert L Bicknell Dr, Suite 3c, Shreveport, LA 71103-3920 | 2015-06-18 |
1053705574 | Wellness Center for Skin Therapy LLC | Nurse Practitioner | 2751 Albert L Bicknell Dr, Suite 1a, Shreveport, LA 71103-3920 | 2015-03-23 |
1295123644 | Melissa L Lynn Md Apmc | Internal Medicine | 2751 Albert L Bicknell Dr, Suite 3c, Shreveport, LA 71103-3920 | 2015-01-07 |
1225433865 | Courtney Moseley | Physician Assistant | 2751 Albert L Bicknell Dr, Suite 3d, Shreveport, LA 71103-3920 | 2014-10-24 |
1831527266 | Wk Robotic and Laparoscopic Surgery Clinic | Surgery | 2751 Albert L Bicknell Dr, Suite 3a, Shreveport, LA 71103-3920 | 2013-10-22 |
1427484534 | Dustin Greg Allen | Physician Assistant | 2751 Albert L Bicknell Dr, Suite 4a, Shreveport, LA 71103-3920 | 2013-09-20 |
1114367976 | Wk North Laparoscopic Surgical Associates | Surgery | 2751 Albert L Bicknell Dr, Suite 3d, Shreveport, LA 71103-3920 | 2013-06-26 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
Find all providers in zip 71103 |
Taxonomy Code | 207XX0005X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Sports Medicine |
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710095690 | Bone & Joint Clinic | Orthopaedic Surgery | 1202 Louisiana Ave, Shreveport, LA 71101-3910 | 2006-08-29 |
1689619769 | R Shane Barton Md and Willis-knighton Medical Center | Orthopaedic Surgery | 7925 Youree Dr, Suite 200, Shreveport, LA 71105-5538 | 2006-06-20 |
1275529083 | Richard Shane Barton | Orthopaedic Surgery | 7925 Youree Dr, Suite 200, Shreveport, LA 71105-5538 | 2005-09-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003337478 | Orthopaedic Clinic of Monroe | Orthopaedic Surgery | 309 Mcmillan Rd, West Monroe, LA 71291-5323 | 2017-07-06 |
1669926887 | Kindl Works LLC | Orthopaedic Surgery | 1570 Lindberg Dr Ste 6, Slidell, LA 70458 | 2016-08-04 |
1033536529 | David Leslie | Orthopaedic Surgery | 1201 S Clearview Pkwy Bldg B, Jefferson, LA 70121-1015 | 2014-03-24 |
1215290580 | Paul Phillips Iv | Orthopaedic Surgery | 478 S Johnson St Fl 6, New Orleans, LA 70112-2238 | 2012-06-20 |
1295938892 | Michael Jesse Mcnulty Iv | Orthopaedic Surgery | 3800 Houma Boulevard, Suite 200, Metairie, LA 70006 | 2007-06-09 |
1205925070 | Ronald D. Sylvest | Orthopaedic Surgery | 7414 Picardy, Ste A, Baton Rouge, LA 70808 | 2006-10-12 |
1336144757 | William S Bundrick | Orthopaedic Surgery | 2449 Hospital Dr Ste 200, Bossier City, LA 71111-2382 | 2005-06-14 |
1013574961 | Ochsner Clinic Foundation | Orthopaedic Surgery | 1221 S Clearview Pkwy, Jefferson, LA 70121-1011 | 2019-05-28 |
1891216263 | Orthopaedic Clinic of Monroe | Orthopaedic Surgery | 707 S Vienna St, Ruston, LA 71270-5845 | 2017-07-06 |
1154876670 | Orthobr LLC | Orthopaedic Surgery | 7414 Picardy Ave, Suite A, Baton Rouge, LA 70808-4696 | 2016-08-25 |
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City | SHREVEPORT |
Zip Code | 71103 |
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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.