PATRICK W PEAVY (NPI# 1669429882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669429882 |
| Entity Type | Individual |
| Full Name | PATRICK W PEAVY |
| Credential | MD |
| Practice Address |
1 Saint Mary Pl Shreveport LA 71101-4343 |
| Mailing Address |
Po Box 44123 Shreveport LA 71134-4123 |
| Practice Telephone | 3182221149 |
| Practice Fax Number | 3184252335 |
| Mailing Telephone | 3182221149 |
| Mailing Fax Number | 3184252335 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD010374 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1184721 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063823094 | Patrick Peavy | Orthopaedic Surgery | 1801 Gadsden Hwy, Birmingham, AL 35235-3134 | 2014-05-13 |
| Street Address |
1 SAINT MARY PL |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447254198 | Walter E Bounds | Emergency Medicine | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2005-06-10 |
| 1083085005 | Valient Emergency Physicians, LLC | Physician Assistant | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2015-10-16 |
| 1356712509 | Sahara Emergency Physicians, LLC | Physician Assistant | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2015-10-14 |
| 1164807723 | Amy Hollis Norcross | Nurse Practitioner | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2015-07-24 |
| 1114270261 | Ghassan Fouad Hamdan | Pharmacist | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2012-10-25 |
| 1730466053 | Michelle Moore Haynie | Nurse Practitioner | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2011-11-15 |
| 1104142769 | Laura Christine Brooks | Nurse Practitioner | 1 Saint Mary Pl, Nicu, Shreveport, LA 71101-4343 | 2010-04-07 |
| 1154656494 | Paul Wesley Chism | Nurse Practitioner | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2009-10-05 |
| 1902030273 | Shannon Leonnie Youngblood | Nurse Anesthetist, Certified Registered | 1 Saint Mary Pl, Pfs-pro Billing, Shreveport, LA 71101-4343 | 2009-05-14 |
| 1467602755 | Childrens Acute Care Inc | Pediatrics | 1 Saint Mary Pl, Box 40, Shreveport, LA 71101-4343 | 2008-09-24 |
| Find all providers in the same location | ||||
| 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 | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801393590 | Sterling Spine, LLC | Radiology | 708 N Ashley Ridge Loop Ste 400, Shreveport, LA 71106-7234 | 2018-04-09 |
| 1992046148 | Benjamin Vickers | Radiology | 8601 Rampart Pl, Shreveport, LA 71106-6227 | 2013-03-13 |
| 1053659672 | Lacy Holmes Williams | Radiology | 416 Travis St, Suite 1200, Shreveport, LA 71101-3282 | 2013-01-17 |
| 1710238100 | Thomas Archie Grant | Radiology | 9392 Stonebriar Cir, Shreveport, LA 71115-3728 | 2012-09-25 |
| 1174569412 | Ginger Auer-baker | Radiology | 708 N Ashley Ridge Loop, Suite #400, Shreveport, LA 71106-7234 | 2006-06-22 |
| 1932108578 | Open Mri of Northwest Louisiana LLC | Radiology | 855 Pierremont Rd, Suite 105, Shreveport, LA 71106-2084 | 2005-07-15 |
| 1548656465 | Evangeline Clinical Services, Inc. | Radiology | 855 Pierremont Rd, Suite 105, Shreveport, LA 71106-2084 | 2015-04-07 |
| 1619396702 | Aya Al Asfari | Radiology | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2014-04-16 |
| 1972947166 | Oluwayemisi M. Ojemakinde | Radiology | 1501 Kings Hwy, Internal Medicine, Shreveport, LA 71103-4228 | 2013-04-18 |
| 1750724555 | Virginia Ann Brown | Radiology | 1501 Kings Hwy, Dept. of Internal Medicine, Shreveport, LA 71103-4228 | 2013-04-10 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
Please comment or provide details below to improve the information on PATRICK W PEAVY.
| 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.