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SOUTH SHREVEPORT FAMILY MEDICINE, LLC
NPI 1013217595
Nurse Practitioner - Family in Shreveport, LA

Active since October 29, 2010
8660 FERN AVE STE 105, SHREVEPORT, LA 71105(318) 797-0009(318) 797-0092 Get Directions Write a Review

NPPES record last updated: October 5, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 5, 2022, Oct 21, 2019 (2 updates tracked since 2019).

About South Shreveport Family Medicine, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH SHREVEPORT FAMILY MEDICINE, LLC (NPI 1013217595) is a healthcare organization registered as a family in Shreveport, Louisiana and active in the NPI registry since October 2010. The organization lists Jon Charles Barnes, Fnp, as its authorized official.

NPPES Registry Identity

NPI1013217595
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameSOUTH SHREVEPORT FAMILY MEDICINE, LLC
Location Address8660 FERN AVE STE 105Shreveport, LA 71105-5657
Mailing Address530 Red Baron DrShreveport, LA 71115-3052 · (318) 349-6728
Phone(318) 797-0009
Fax(318) 797-0092
Organization SubpartNo
Authorized OfficialJon Charles BarnesFnp · (318) 349-6728
Enumeration DateOctober 29, 2010
Last NPPES UpdateOctober 5, 20222 updates tracked since enumeration
NPPES CertifiedOctober 5, 2022
✔ NPI 1013217595 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedFamily MedicineTaxonomy 207Q00000X
8660 FERN AVE STE 105, Shreveport, LA 71105
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Other Identifiers 1

Medicaid1131831LA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JON C BARNES FNP
Nurse Practitioner (Family)
8660 FERN AVE STE 105
SHREVEPORT, LA 71105
Caddo Parish (318) 797-0009

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Shreveport Family Medicine, LLC's NPI number?

The NPI number for South Shreveport Family Medicine, LLC is 1013217595. It was assigned to this organization in the NPPES registry on October 29, 2010.

Where is South Shreveport Family Medicine, LLC located?

South Shreveport Family Medicine, LLC is located at 8660 Fern Ave Ste 105, Shreveport, LA 71105. The listed phone number is (318) 797-0009.

What is South Shreveport Family Medicine, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for South Shreveport Family Medicine, LLC was last updated on October 5, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.