GERARDO SANTOS SAN PEDRO (NPI# 1336166255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336166255 |
| Entity Type | Individual |
| Full Name | GERARDO SANTOS SAN PEDRO |
| Credential | M.D. |
| Practice Address |
2400 Hospital Dr Ste 340 Bossier City LA 71111-2387 |
| Mailing Address |
2400 Hospital Dr Ste 340 Bossier City LA 71111-2387 |
| Practice Telephone | 3187472277 |
| Practice Fax Number | 3187472217 |
| Mailing Telephone | 3187472277 |
| Mailing Fax Number | 3187472217 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
11657R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1680877 | 05 |
| Street Address |
2400 HOSPITAL DR STE 340 |
| City | BOSSIER CITY |
| State | LA |
| Zip Code | 71111-2387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588126007 | Patrice Ware Kingsley | Nurse Practitioner | 2400 Hospital Dr Ste 340, Bossier City, LA 71111-2387 | 2019-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669007951 | Tamara 'tammy' Larck | Counselor | 1525 Fullilove Drive, Shreveport, LA 71111 | 2020-03-06 |
| 1912538315 | Lagniappe Chiropractic | Chiropractor | 2400 Airline Drive, Bossier City, LA 71111 | 2020-02-04 |
| 1649817420 | Lifecare Medical Transportation, LLC. | Non-emergency Medical Transport (VAN) | 25 Duck Haven Pointe, Bossier City, LA 71111 | 2019-11-29 |
| 1770126344 | Bertresea White Evans | Nurse Practitioner | Coastal Urgernt Care, 5314 Airline Drive, Bossier City, LA 71111 | 2019-10-25 |
| 1861964058 | Erika Davis Reed | Counselor | 1515 Doctors Dr # 16, Bossier City, LA 71111 | 2018-12-28 |
| 1518436898 | Charlotte Mckay | Case Manager/Care Coordinator | 31330 Hwy 22, Ste 101, Bossier City, LA 71111 | 2018-11-16 |
| 1992271464 | Np2u, LLC | Nurse Practitioner | 2008 Airline Drive Suite 300 #194, Bossier City, LA 71111 | 2018-10-22 |
| 1114416542 | Lashaunda Autrey | Counselor | 410 Half Moon Lane, Bossier, LA 71111 | 2018-05-01 |
| 1750887196 | Shenya Williams-pennywell | Counselor | 1007 Gould Drive Bldg 2, Suite 1, Bossier City, LA 71111 | 2018-04-04 |
| 1336647304 | Patrick Vance | Physical Therapist | 5000 Benton Rd Ste 1, Bossier City, LA 71111 | 2018-01-24 |
| Find all providers in zip 71111 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215149331 | Wk Bossier Pulmonary & Critical Care Clinic | Internal Medicine | 2400 Hospital Dr, Suite 340, Bossier City, LA 71111-2385 | 2007-05-03 |
| 1659418309 | Red River Pulmonary Critical Care and Sleep Disorders Clinic LLC | Internal Medicine | 2400 Hospital Dr, Suite 340, Bossier City, LA 71111-2385 | 2007-01-31 |
| 1457347429 | Raghu P Nathan | Internal Medicine | 2400 Hospital Dr, Suite 340, Bossier City, LA 71111-2385 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992243349 | Francesco Simeone LLC | Internal Medicine | 7824 Freret St, New Orleans, LA 70118-3916 | 2017-02-06 |
| 1164870168 | Louisiana Pulmonary, LLC | Internal Medicine | 213 South Dr, Natchitoches, LA 71457-5003 | 2016-05-31 |
| 1316271356 | Critical Care Coverage LLC | Internal Medicine | 624 Travis St Ste 300, Shreveport, LA 71101-3014 | 2009-09-23 |
| 1053545152 | Marlon Andre Medford | Internal Medicine | 211 4th St Ste 200, Alexandria, LA 71301-8421 | 2009-05-05 |
| 1174644801 | Richard Louis Morrison | Internal Medicine | 48 Metairie Ct, Metairie, LA 70001-3032 | 2007-04-02 |
| 1366486292 | Christopher Bryan Thomas | Internal Medicine | 8585 Picardy Ave Ste 313, Baton Rouge, LA 70809-3749 | 2006-06-14 |
| 1487653804 | Stephanie J Blair | Internal Medicine | 211 4th St, Alexandria, LA 71301-8421 | 2005-07-18 |
| 1780689224 | Calvin D. Alexander | Internal Medicine | 6046 S Lakeshore Dr, Shreveport, LA 71119-3704 | 2005-06-20 |
| 1073518510 | Stuart John Lebas | Internal Medicine | 500 Rue De La Vie St Ste 513, Baton Rouge, LA 70817-5129 | 2005-06-20 |
| 1619463916 | Gulfsouth Pulmonology, LLC | Internal Medicine | 1970 N Highway 190, Covington, LA 70433 | 2018-07-10 |
| Find all providers with the same taxonomy | ||||
| City | BOSSIER CITY |
| Zip Code | 71111 |
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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.