WILLIS KNIGHTON MEDICAL CENTER, INC. (NPI# 1730645201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730645201 |
| Entity Type | Organization |
| Organization Name | WILLIS KNIGHTON MEDICAL CENTER, INC. |
| Other Organization Name | WK OUTPATIENT LAB SERVICES |
| Practice Address |
2600 Greenwood Rd Shreveport LA 71103-3908 |
| Mailing Address |
Po Box 32600 Shreveport LA 71130-2600 |
| Practice Telephone | 3182124000 |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-03-08 |
| Authorized Official Name | MICHAEL SCOTT COOK (ACCOUNTANT) |
| Authorized Official Telephone | 3182124544 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| WK Outpatient Lab Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710039896 | Willis Knighton Medical Center, Inc. | Rehabilitation Unit | 1111 Line Avenue, Shreveport, LA 71101 | 2007-01-17 |
| 1144267451 | Willis Knighton Medical Center, Inc. | Skilled Nursing Facility | 2550 Kings Hwy, Shreveport, LA 71103-3922 | 2006-06-02 |
| 1003020579 | Willis Knighton Medical Center, Inc. | Clinic/Center | 1111 Line Avenue, Shreveport, LA 71101 | 2007-05-10 |
| 1912059932 | Willis Knighton Medical Center, Inc. | Psychiatric Unit | 1111 Line Avenue, Shreveport, LA 71101 | 2007-01-18 |
| 1124170691 | Willis Knighton Medical Center, Inc. | General Acute Care Hospital | 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118-3119 | 2007-01-17 |
| 1003968579 | Willis Knighton Medical Center, Inc. | General Acute Care Hospital | 2400 Hospital Dr, Bossier City, LA 71111-2385 | 2007-01-17 |
| 1275685539 | Willis Knighton Medical Center, Inc. | General Acute Care Hospital | 8001 Youree Dr, Shreveport, LA 71115-2302 | 2007-01-17 |
| 1487693149 | Willis Knighton Medical Center, Inc. | Hospice Care, Community Based | 3300 Albert L Bicknell Dr, Suite 3, Shreveport, LA 71103-3903 | 2006-06-06 |
| 1326093782 | Willis Knighton Medical Center, Inc. | Home Health | 3300 Albert L Bicknell Dr, Suite 4, Shreveport, LA 71103-3903 | 2006-05-24 |
| 1568461572 | Willis Knighton Medical Center, Inc. | General Acute Care Hospital | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2005-07-20 |
| Street Address |
2600 GREENWOOD RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-3908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972508307 | Mary Cecola | Nurse Anesthetist, Certified Registered | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2005-06-13 |
| 1427675701 | Lakyn Paige Smith | Nurse Practitioner | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2020-07-02 |
| 1013497114 | Cross Lake Emergency Group, LLC | Physician Assistant | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2018-08-17 |
| 1417479262 | Kristen Mccoy Keener | Nurse Practitioner | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2017-07-13 |
| 1689110538 | Penny Lynn Ford | Nurse Anesthetist, Certified Registered | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2017-01-17 |
| 1427508456 | Edward Glenn Bernatowicz | Pharmacist | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2016-10-13 |
| 1306237391 | Christina Maxwell | Nurse Anesthetist, Certified Registered | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2015-02-11 |
| 1467841270 | Houston Lacobee | Nurse Anesthetist, Certified Registered | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2015-01-16 |
| 1740688415 | Ana Costea | Emergency Medicine | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2014-12-12 |
| 1801205802 | Wkmc Cardiovascular Consultants | Internal Medicine | 2600 Greenwood Rd, Shreveport, LA 71103-3908 | 2014-08-05 |
| 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 | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336762269 | Louisiana State University Health Sciences Center Shreveport | Clinical Medical Laboratory | 1505 Kings Highway, 2nd Floor Bri Building, Shreveport, LA 71103-4228 | 2020-05-27 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1730548504 | Tlm Diagnostics LLC | Clinical Medical Laboratory | 9441 Stevens Rd, Suite 100, Shreveport, LA 71106-7567 | 2016-02-22 |
| 1710237615 | Med-consult, Inc | Clinical Medical Laboratory | 8575 Fern Ave Ste 110, Shreveport, LA 71105-5677 | 2012-09-18 |
| 1215258645 | Ark-la-tex, LLC | Clinical Medical Laboratory | 3029 Risinger Dr, Shreveport, LA 71119-2716 | 2010-06-21 |
| 1144363169 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 301 Bert Kouns, Shreveport, LA 71106 | 2007-02-15 |
| 1881677078 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1455 E Bert Kouns Industrial Loop, Shreveport, LA 71105-5634 | 2005-11-22 |
| 1649279910 | The Delta Pathology Group, L.L.C. | Clinical Medical Laboratory | 2915 Missouri Ave, Shreveport, LA 71109-4327 | 2005-07-19 |
| 1942853551 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 850 Olive St Ste A, Shreveport, LA 71104-2162 | 2019-07-23 |
| 1629402086 | Gnd Operating, LLC | Clinical Medical Laboratory | 3939 Lakeshore Dr, Ste 4, Shreveport, LA 71109-1925 | 2013-08-21 |
| Find all providers in SHREVEPORT | ||||
| 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.