HIGHLAND CLINIC, A PROF MED CORP (NPI# 1609297449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609297449 |
| Entity Type | Organization |
| Organization Name | HIGHLAND CLINIC, A PROF MED CORP |
| Practice Address |
1455 E Bert Kouns Industrial Loop # 101 Shreveport LA 71105-5634 |
| Mailing Address |
Po Box 415000 Msc# 410777 Nashville TN 37241-0777 |
| Practice Telephone | 3187984616 |
| Practice Fax Number | 3187984619 |
| Mailing Telephone | 3187984539 |
| Mailing Fax Number | 3187984601 |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2020-03-26 |
| Authorized Official Name | DEBBIE W SMITH (CEO) |
| Authorized Official Telephone | 3187984598 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | LA | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897743 | Highland Clinic, A Prof Med Corp | Orthopaedic Surgery | 5025 Shed Rd, Bossier City, LA 71111-5434 | 2020-09-24 |
| 1891168761 | Highland Clinic, A Prof Med Corp | Ophthalmology | 1400 E Bert Koun Loop, #103, Shreveport, LA 71105-5603 | 2015-11-02 |
| 1700259678 | Highland Clinic, A Prof Med Corp | Orthopaedic Surgery | 1453 E Bert Koun Loop, #210, Shreveport, LA 71105-6800 | 2015-11-02 |
| 1477925063 | Highland Clinic, A Prof Med Corp | Ophthalmology | 471 Ashley Ridge Blvd, Shreveport, LA 71106-7229 | 2015-10-22 |
| 1053315846 | Highland Clinic, A Prof Med Corp | Clinic/Center | 1455 E Bert Kouns Loop, Shreveport, LA 71105-5634 | 2005-06-09 |
| Street Address |
1455 E BERT KOUNS INDUSTRIAL LOOP # 101 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1396290060 | New Tech | Non-Pharmacy Dispensing Site | 410 Kay Ln, Shreveport, LA 71115-3604 | 2016-08-23 |
| 1063717841 | Practicemd, Inc. | Non-Pharmacy Dispensing Site | 242 Lynbrook Blvd, Shreveport, LA 71106-6548 | 2011-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461593 | Scott G Petrie Md Apmc | Non-Pharmacy Dispensing Site | 1014 West St Clare Boulevard, Ste 1020, Gonzales, LA 70737 | 2020-09-15 |
| 1689282576 | Total Access Mobility Services | Non-Pharmacy Dispensing Site | 500 Port of New Orleans Pl, New Orleans, LA 70130-1662 | 2020-07-17 |
| 1023570348 | Patrick A Juneau, IIi, Md, Apmc | Non-Pharmacy Dispensing Site | 1103 Kaliste Saloom Rd Ste 206, Lafayette, LA 70508-5784 | 2019-04-04 |
| 1306304050 | Spinal Regeneration Center of La, LLC | Non-Pharmacy Dispensing Site | 189 Greenbrier Blvd Ste C, Covington, LA 70433-7297 | 2019-03-12 |
| 1700356789 | John R. Macgregor Jr. M.d. (apmc) | Non-Pharmacy Dispensing Site | 1502 West Causeway Approach, Suite D, Mandeville, LA 70471 | 2018-12-03 |
| 1124502505 | Orthopaedic Clinic of Monroe | Non-Pharmacy Dispensing Site | 1501 Louisville Ave., Monroe, LA 71201 | 2018-09-20 |
| 1902385354 | Wm. Andre Cenac, Md Apmc | Non-Pharmacy Dispensing Site | 1307 Old Jeanerette Rd Ste 100, New Iberia, LA 70563-5801 | 2018-08-07 |
| 1801394820 | Acadiana Ambulatory Health Care Services | Non-Pharmacy Dispensing Site | 207 Westmark Blvd., Lafayette, LA 70506 | 2018-01-24 |
| 1144734153 | Northshore Interventional Pain Management | Non-Pharmacy Dispensing Site | 7015 Hwy 190 E Service Rd., Ste 101, Covington, LA 70433 | 2017-11-29 |
| 1356854103 | Jencare Neighborhood Medical Metairie, LLC. | Non-Pharmacy Dispensing Site | Jencare Neighborhood Medical Center Uptown, 2820 Napoleon Avenue, Suite 590, New Orleans, LA 70115 | 2017-11-14 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on HIGHLAND CLINIC, A PROF MED CORP.
| 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.