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WK PEDIATRIC INTENSIVIST
NPI 1023074549
Pediatrics - Pediatric Critical Care Medicine in Shreveport, LA

Active since April 24, 2006
2510 BERT KOUN LOOP RM 4003, SHREVEPORT, LA 71118(318) 212-5665(318) 212-5698 Get Directions Write a Review

NPPES record last updated: May 9, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Wk Pediatric Intensivist NPPES

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

WK PEDIATRIC INTENSIVIST (NPI 1023074549) is a healthcare organization registered as a pediatric critical care medicine in Shreveport, Louisiana and active in the NPI registry since April 2006. The organization lists Greg J. Gavin, Network Administrator, as its authorized official.

NPPES Registry Identity

NPI1023074549
Entity TypeOrganization
Primary Taxonomy2080P0203X
Legal Business NameWK PEDIATRIC INTENSIVIST
Location Address2510 BERT KOUN LOOP RM 4003Shreveport, LA 71118-3119
Mailing Address2510 Bert Koun Loop Rm 4003Shreveport, LA 71118-3119 · (318) 212-5665 · Fax (318) 212-5698
Phone(318) 212-5665
Fax(318) 212-5698
Organization SubpartNo
Authorized OfficialGreg J. GavinNetwork Administrator · (318) 212-3868
Enumeration DateApril 24, 2006
Last NPPES UpdateMay 9, 2018
✔ NPI 1023074549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
2510 BERT KOUN LOOP RM 4003, Shreveport, LA 71118
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Other Identifiers 1

Medicaid1099091LA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wk Pediatric Intensivist is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Wk Pediatric Intensivist, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Craig Chu, M.D.
Pediatric Medicine
NPI 1164740262
2508 BERT KOUNS INDUSTRIAL LOOP STE 320
Shreveport, LA 71118
(318) 212-5990
✔ PECOS0.1 mi
Shannon Faulkinberry, MD, MPH
Pediatric Medicine
NPI 1104246545
2510 BERT KOUNS INDUSTRIAL LOOP
Shreveport, LA 71118
(318) 212-5665
✔ PECOS0.1 mi
Minh Tran, M.D.
Pediatric Medicine
NPI 1194059386
800 E DAWSON ST
Tyler, TX 75701
(903) 606-7264
✔ PECOS88 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Wk Pediatric Intensivist's NPI number?

The NPI number for Wk Pediatric Intensivist is 1023074549. It was assigned to this organization in the NPPES registry on April 24, 2006.

Where is Wk Pediatric Intensivist located?

Wk Pediatric Intensivist is located at 2510 Bert Koun Loop Rm 4003, Shreveport, LA 71118. The listed phone number is (318) 212-5665.

What is Wk Pediatric Intensivist's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Wk Pediatric Intensivist enrolled in Medicare?

Yes. Wk Pediatric Intensivist is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wk Pediatric Intensivist?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Pediatric Medicine, reassign their Medicare billing to Wk Pediatric Intensivist. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Wk Pediatric Intensivist accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Blue Cross and Blue Shield of Louisiana and 1 other insurer list Wk Pediatric Intensivist as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wk Pediatric Intensivist was last updated on May 9, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.