WK TRI-STATE MEDICAL CLINIC
NPI 1225082746
Internal Medicine in Shreveport, LA
About Wk Tri-state Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WK TRI-STATE MEDICAL CLINIC (NPI 1225082746) is a healthcare organization registered as an internal medicine in Shreveport, Louisiana and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through May 15, 2028 and lists Greg J. Gavin, Network Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Accepted 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 Tri-state Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
13Medicare enrollment records show 13 clinicians reassign Medicare billing to Wk Tri-State Medical Clinic, which bills Medicare for the services they deliver. Of these, 12 practice at this address and 13 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (13)
Shreveport, LA 71103
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 19D1054271
Wk Tri State Medical Clinic · Shreveport, LAFrequently 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 Tri-State Medical Clinic's NPI number?
The NPI number for Wk Tri-State Medical Clinic is 1225082746. It was assigned to this organization in the NPPES registry on May 20, 2006.
Where is Wk Tri-State Medical Clinic located?
Wk Tri-State Medical Clinic is located at 2551 Greenwood Rd Suite 410, Shreveport, LA 71103. The listed phone number is (318) 621-2929.
What is Wk Tri-State Medical Clinic's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Wk Tri-State Medical Clinic enrolled in Medicare?
Yes. Wk Tri-State Medical Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Wk Tri-State Medical Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians in 2 Medicare specialties reassign their Medicare billing to Wk Tri-State Medical Clinic. 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. The largest specialties are Internal Medicine (10) and Nurse Practitioner (3). Of these, 12 practice at this address and 13 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Wk Tri-State Medical Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 19D1054271) is associated with this NPI, valid through May 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Wk Tri-State Medical Clinic 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 Tri-State Medical Clinic 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 Tri-State Medical Clinic was last updated on October 5, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Wk Tri-State Medical Clinic · NPI 1225082746
Internal Medicine organization in Shreveport, Louisiana. Organization record, active in the CMS NPPES registry since May 20, 2006.
## Identity
- **NPI:** 1225082746 (Entity type: Organization)
- **Enumerated:** May 20, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Greg Gavin, NETWORK ADMINISTRATOR
## Practice location
- **Address:** 2551 GREENWOOD RD, SUITE 410, Shreveport, LA 71103-3981
- **Phone:** (318) 621-2929 · **Fax:** (318) 621-2930
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 13 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (10), Nurse Practitioner (3); 12 practice at this address and 13 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 5, 2012
- **Other identifiers:** Medicare PIN 5CU97 (LA); Medicaid 1448419 (LA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1225082746) · Data from the CMS NPPES public registry.