BREAST CARE SPECIALISTS AMC (NPI# 1821127978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821127978 |
| Entity Type | Organization |
| Organization Name | BREAST CARE SPECIALISTS AMC |
| Practice Address |
1666 E Bert Kouns Industrial Loop Suite 230 Shreveport LA 71105-5714 |
| Mailing Address |
Po Box 52286 Shreveport LA 71135-2286 |
| Practice Telephone | 3186877117 |
| Mailing Telephone | 3186877117 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CHRISTOPHER S. SOCKRIDER (PRINCIPAL OFFICER) |
| Authorized Official Telephone | 3186877117 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
1666 E BERT KOUNS INDUSTRIAL LOOP SUITE 230 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306875570 | Edward Ronald Samper | Emergency Medicine | 1666 E Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71105-5714 | 2006-07-01 |
| 1326488347 | Abigail Tillman | Family Medicine | 1666 E Bert Kouns Industrial Loop, Shreveport, LA 71105 | 2013-07-05 |
| 1891822714 | Cheryl Austin Smith, Md, Inc. | Family Medicine | 1666 E Bert Kouns Industrial Loop, Suite 225, Shreveport, LA 71105-5714 | 2007-02-27 |
| 1073612727 | Swearingen and Bryan | Specialist | 1666 E Bert Kouns Industrial Loop, Ste 235, Shreveport, LA 71105-5714 | 2006-09-21 |
| 1235247230 | Cheryl A Smith | Family Medicine | 1666 E Bert Kouns Industrial Loop, Suite 225, Shreveport, LA 71105-5714 | 2006-08-29 |
| 1598797789 | Stephen Alan Smith | Family Medicine | 1666 E Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71105-5714 | 2006-07-07 |
| 1003847013 | Paul S Wilson Md and Willis-knighton Medical Center | Internal Medicine | 1666 E Bert Kouns Industrial Loop, Suite 230, Shreveport, LA 71105-5714 | 2006-07-06 |
| 1629008214 | John Gordon Goddard | Family Medicine | 1666 E Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71105-5714 | 2006-07-03 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730663907 | Ida Molavi | Surgery | Department of Surgery, 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2018-09-24 |
| 1962500850 | Minimally Invasive Surgery Center of Louisiana | Surgery | 1534 Elizabeth Ave Ste 400, Shreveport, LA 71101-4531 | 2006-09-21 |
| 1104846989 | Kevin Mark Sittig | Surgery | 1541 Kings Hwy Dept Of, Shreveport, LA 71103-4228 | 2006-07-21 |
| 1285670356 | George Robert Merriman II | Surgery | 949 Olive St, Shreveport, LA 71104-2103 | 2006-06-20 |
| 1417900416 | Milon G Karmakar | Surgery | 3300 Albert L Bicknell Dr, Suite 6, Shreveport, LA 71103-3903 | 2006-05-18 |
| 1821054214 | John Davidson Gladney | Surgery | 8001 Youree Drive, Suite 840, Shreveport, LA 71115-2302 | 2006-04-25 |
| 1801890769 | F Dean Griffen | Surgery | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2005-06-09 |
| 1053315903 | James Booth Burke | Surgery | 1202 Louisiana Avenue, Shreveport, LA 71101-3910 | 2005-06-09 |
| 1760486609 | William Lewis Norwood Jr. | Surgery | 2751 Albert Bicknell Drive, Suite 3a, Shreveport, LA 71103-3976 | 2005-06-09 |
| 1619588019 | Wk Minimally Invasive Surgery Center | Surgery | 2751 Albert L Bicknell Dr Ste 3a, Shreveport, LA 71103-3976 | 2020-08-11 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
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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.