WK HEART AND VASCULAR INSTITUTE CHF CLINIC (NPI# 1972043511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972043511 |
| Entity Type | Organization |
| Organization Name | WK HEART AND VASCULAR INSTITUTE CHF CLINIC |
| Practice Address |
2727 Hearne Ave Shreveport LA 71103-3917 |
| Mailing Address |
1202 Louisiana Ave Shreveport LA 71101-3910 |
| Practice Telephone | 3182124791 |
| Practice Fax Number | 3182124307 |
| Mailing Telephone | 3182124791 |
| Mailing Fax Number | 3182124307 |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |
| Authorized Official Name | GREG J GAVIN (ADMINISTRATOR) |
| Authorized Official Telephone | 3182128951 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Street Address |
2727 HEARNE AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-3917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255321881 | Michael Glen Walton | Internal Medicine | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3917 | 2005-10-25 |
| 1831633510 | Kerri Lavigne | Physician Assistant | 2727 Hearne Ave, 300, Shreveport, LA 71103-3917 | 2016-12-14 |
| 1063963890 | Alex Stewart | Nurse Practitioner | 2727 Hearne Ave, Ste 300, Shreveport, LA 71103-3917 | 2016-10-17 |
| 1710366570 | James Clay Harris | Nurse Practitioner | 2727 Hearne Ave, Suite 301, Shreveport, LA 71103-3917 | 2015-05-27 |
| 1487914453 | Amy Myers Brainis | Nurse Practitioner | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3917 | 2012-05-23 |
| 1871877407 | Cassie James Miller | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3917 | 2011-09-30 |
| 1952610883 | Shannon Lea Betzing | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3931 | 2010-09-27 |
| 1134457757 | Kelli Marie Neal | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3931 | 2009-11-19 |
| 1306173638 | Amanda Mariah Savoie | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3931 | 2009-11-06 |
| 1609058395 | Angela H Pharr | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3931 | 2007-12-04 |
| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104281476 | White Clover, LLC | Internal Medicine | 8835 Line Ave Ste 400, Shreveport, LA 71106-6730 | 2015-12-30 |
| 1831331842 | Vieux Carre Investments, LLC | Internal Medicine | 8730 Youree Dr Ste B, Shreveport, LA 71115-2518 | 2009-04-06 |
| 1184720393 | Joseph L. Fredi | Internal Medicine | 1811 E Bert Kouns Industrial Loop Ste 210, Shreveport, LA 71105 | 2006-09-15 |
| 1255321881 | Michael Glen Walton | Internal Medicine | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3917 | 2005-10-25 |
| 1760472419 | Paul Corkran Davis | Internal Medicine | 1453 E Bert Koun Loop Ste 112, Shreveport, LA 71105-6810 | 2005-10-25 |
| 1801886585 | Robert Tate Martin | Internal Medicine | 1811 E Bert Kouns Industrial Loop # 210, Shreveport, LA 71105 | 2005-10-25 |
| 1669472155 | Sanders Fowler Hearne | Internal Medicine | 1811 E Bert Kouns, Suite 100, Shreveport, LA 71115 | 2005-07-26 |
| 1588664080 | William Howard Haynie Jr. | Internal Medicine | 1453 E Bert Koun Loop, Ste 112, Shreveport, LA 71105-6800 | 2005-07-26 |
| 1881127090 | Advanced Cardiovascular Specialists | Internal Medicine | 1453 E Bert Koun Loop, Ste 112, Shreveport, LA 71105-6800 | 2017-04-05 |
| 1063963189 | Basel Kasabali Md Apmc | Internal Medicine | 1800 Irving Pl, Shreveport, LA 71101-4608 | 2016-10-24 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on WK HEART AND VASCULAR INSTITUTE CHF CLINIC.
| 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.