SHREVEPORT ENDOSCOPY CENTER, A MEDICAL CORPORATION


Address: 3217 Mabel St, Shreveport, LA 71103-4022
Phone: 3186310072

SHREVEPORT ENDOSCOPY CENTER, A MEDICAL CORPORATION (NPI# 1982676771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1982676771
Entity Type Organization
Organization Name SHREVEPORT ENDOSCOPY CENTER, A MEDICAL CORPORATION
Practice Address 3217 Mabel St
Shreveport
LA 71103-4022
Practice Telephone 3186310072
Practice Fax Number 3186386018
Mailing Telephone 3186310072
Mailing Fax Number 3186386018
Enumeration Date 2006-02-06
Last Update Date 2018-06-25
Authorized Official Name DR. SATHYA JAGANMOHAN (PRESIDENT)
Authorized Official Telephone 3186310072
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QE0800X Clinic/Center
Specialization: Endoscopy
50 LA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
LA DEA FS0747230 01
LA STATE LICENSE 50 01
LA 1910678 05

Office Location

Street Address 3217 MABEL ST
City SHREVEPORT
State LA
Zip Code 71103-4022

Providers in the same location

NPI Name Taxonomy Address Enumeration
1861495822 Michael Bivens Brannan Internal Medicine 3217 Mabel St, Shreveport, LA 71103-4022 2005-05-24
1770083164 Shreveport Sedation Associates LLC Nurse Anesthetist, Certified Registered 3217 Mabel St, Shreveport, LA 71103-4022 2018-02-13
1275051229 Dustin Lane Chapman Hadley Physician Assistant 3217 Mabel St, Shreveport, LA 71103 2017-08-30
1316492770 Angela Price Booker Nurse Practitioner 3217 Mabel St, Shreveport, LA 71103-4022 2016-08-15
1497101091 Daniel Robert Martin Dietitian, Registered 3217 Mabel St, Shreveport, LA 71103-4022 2016-05-12
1386997351 Jeremy Payne Davis Nurse Practitioner 3217 Mabel St, Shreveport, LA 71103-4022 2012-10-16
1659677540 Brandi Barber Stephens Nurse Practitioner 3217 Mabel St, Shreveport, LA 71103-4022 2011-02-10
1932349412 Natravis R. Cox Internal Medicine 3217 Mabel St, Shreveport, LA 71103 2009-02-24
1518105774 Lauren Malu Strange Nurse Anesthetist, Certified Registered 3217 Mabel St, Shreveport, LA 71103-4022 2009-01-27
1922254002 Joann E Warrick Colon & Rectal Surgery 3217 Mabel St, Shreveport, LA 71103 2008-08-08
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QE0800X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Endoscopy

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1013178417 Gonzales Endoscopy Center LLC Clinic/Center 1433 E Highway 30, Gonzales, LA 70737-4765 2008-06-19
1447324132 Endocenter, LLC Clinic/Center 131-a Cherokee Rose Lane, Covington, LA 70433-7195 2006-11-17
1821014473 Mga Gastrointestinal Diagnostic & Therapeutic-metairie Clinic/Center 3333 Kingman St, 202, Metairie, LA 70006-4236 2006-07-15
1184605792 Colonnade Endoscopy Center LLC Clinic/Center 555 Dr Michael Debakey Dr Ste 102, Lake Charles, LA 70601 2005-11-10
1417957796 Endoscopy Center of Monroe, Inc. Clinic/Center 316 S 6th St, Monroe, LA 71201-7568 2005-07-28
1073519195 Alliance Surgery Center LLC Clinic/Center 3717 Houma Blvd, Ste 200, Metairie, LA 70006-4115 2005-06-23
1255865937 Nga Endoscopy Center LLC Clinic/Center 7015 Highway 190 East Service Rd, Ste 102, Covington, LA 70433-4960 2017-04-19
1497064406 Calche Surgery Center Clinic/Center 8030 Crowder Blvd, New Orleans, LA 70127-1063 2010-09-26
1003067844 Endocenter LLC Clinic/Center 58515 Pearl Acres Rd, Slidell, LA 70461-5423 2008-10-09
1578744470 Mga Gastrointestinal Diagnostic & Therapeutic Center Clinic/Center 2633 Napoleon Ave, Suite 707, New Orleans, LA 70115-6357 2007-11-19
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Competitor

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City SHREVEPORT
Zip Code 71103

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Dataset Information

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.

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