ATOSSA STANLEY MD AND WILLIS-KNIGHTON MEDICAL CENTER (NPI# 1639106065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639106065 |
| Entity Type | Organization |
| Organization Name | ATOSSA STANLEY MD AND WILLIS-KNIGHTON MEDICAL CENTER |
| Practice Address |
2551 Greenwood Rd Suite 310 Shreveport LA 71103-3981 |
| Practice Telephone | 3182128780 |
| Practice Fax Number | 3182124153 |
| Mailing Telephone | 3182128780 |
| Mailing Fax Number | 3182124153 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GREG J GAVIN (NETWORK ADMINISTRATOR) |
| Authorized Official Telephone | 3182128780 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
2551 GREENWOOD RD SUITE 310 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-3981 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061959 | Amit Ahuja | Internal Medicine | 2551 Greenwood Rd, Suite 350, Shreveport, LA 71103-3981 | 2005-05-31 |
| 1457884819 | Wk Center for Endocrinology and Diabetes | Internal Medicine | 2551 Greenwood Rd, Suite 411, Shreveport, LA 71103-3981 | 2017-04-04 |
| 1053762146 | Caleb Harkins | Nurse Practitioner | 2551 Greenwood Rd, Suite #210, Shreveport, LA 71103-3981 | 2016-06-29 |
| 1538513429 | Wk Tri- State Neurosurgery Associates | Neurological Surgery | 2551 Greenwood Rd, Suite 320, Shreveport, LA 71103-3981 | 2016-04-18 |
| 1417326927 | Wk Advanced Laparoscopic and Robotic Surgery Specialists | Surgery | 2551 Greenwood Rd, Suite 310, Shreveport, LA 71103-3981 | 2015-09-15 |
| 1942678511 | James Reginald Hall IIi | Nurse Practitioner | 2551 Greenwood Rd, Suite 410, Shreveport, LA 71103-3981 | 2015-09-12 |
| 1437545282 | Wk North Hospitalists Group | Hospitalist | 2551 Greenwood Rd, Suite 410, Shreveport, LA 71103-3981 | 2015-04-08 |
| 1891198354 | Julie Kajor Broadwell | Physician Assistant | 2551 Greenwood Rd, Suite 140, Shreveport, LA 71103-3981 | 2014-09-29 |
| 1124467733 | Ambrosia T. Holsapple | Nurse Practitioner | 2551 Greenwood Rd, Suite 410, Shreveport, LA 71103-3981 | 2013-06-17 |
| 1528406915 | Wkn Tristate Neurology Clinic | Neurological Surgery | 2551 Greenwood Rd, Suite 240, Shreveport, LA 71103-3981 | 2013-06-07 |
| Find all providers in the same location | ||||
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922621390 | Partners In Primary Care La PC | Family Medicine | 7551 Youree Dr Ste 11, Shreveport, LA 71105-5533 | 2020-05-20 |
| 1528609104 | Spectra Family Clinic, LLC | Family Medicine | 9300 Mansfield Rd Ste 209, Shreveport, LA 71118-3138 | 2019-10-04 |
| 1922502327 | Courtney Morgan | Family Medicine | 723 Milam St, Shreveport, LA 71101-3507 | 2018-03-20 |
| 1174973317 | Patrick Michael Fitz-gerald | Family Medicine | 731 Coachlight Rd, Shreveport, LA 71106-7205 | 2016-06-19 |
| 1437446341 | Samreena N Sara | Family Medicine | 8835 Line Ave Ste 400a, Shreveport, LA 71106-6722 | 2011-06-30 |
| 1932490554 | Michael Thomas Kitchell | Family Medicine | 1666 E Bert Koun Loop Ste 105, Shreveport, LA 71105-5718 | 2011-04-30 |
| 1831402254 | David J. Colvin Md LLC | Family Medicine | 148 Waters Edge Dr, Shreveport, LA 71106-7774 | 2010-07-15 |
| 1952628802 | Tri Pham | Family Medicine | 133 Charles Ave, Shreveport, LA 71105-3719 | 2010-04-30 |
| 1669799524 | Stephanie James | Family Medicine | 2120 Bert Kouns Industrial Loop Ste M, Shreveport, LA 71118-3355 | 2010-04-30 |
| 1205062965 | Charles Henry Nash | Family Medicine | 5935 Gilbert Dr, Shreveport, LA 71106-2315 | 2009-06-08 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on ATOSSA STANLEY MD AND WILLIS-KNIGHTON MEDICAL CENTER.
| 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.