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GIBSON FAMILY PRACTICE
NPI 1316418288
Family Medicine - Addiction Medicine in Shreveport, LA

Active since December 17, 2018CLIA 19D2198123 · Waiver
1549 ELIZABETH AVE, SHREVEPORT, LA 71101(318) 918-0058 Get Directions Write a Review

NPPES record last updated: October 26, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 26, 2020, Dec 17, 2018 (2 updates tracked since 2018).

About Gibson Family Practice NPPES

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

GIBSON FAMILY PRACTICE (NPI 1316418288) is a healthcare organization registered as an addiction medicine in Shreveport, Louisiana and active in the NPI registry since December 2018. The organization holds a CLIA Waiver certificate valid through October 28, 2026, maintains a secondary practice location in Shreveport, and lists William Lee Gibson, Manager, as its authorized official.

NPPES Registry Identity

NPI1316418288
Entity TypeOrganization
Primary Taxonomy207QA0401X
Legal Business NameDRG MEDICAL LLC
Location Address1549 ELIZABETH AVEShreveport, LA 71101-4501
Mailing Address1549 Elizabeth AveShreveport, LA 71101-4501 · (318) 918-0058
Phone(318) 918-0058
Organization SubpartNo
Authorized OfficialWilliam Lee GibsonManager · (318) 918-0058
Enumeration DateDecember 17, 2018
Last NPPES UpdateOctober 26, 20202 updates tracked since enumeration
NPPES CertifiedOctober 26, 2020
✔ NPI 1316418288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
Definition

A family medicine physician who specializes in the diagnosis and treatment of addictions.

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
1549 ELIZABETH AVE, Shreveport, LA 71101
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Other Names 1

Doing Business AsGibson Family Practice

Secondary Practice Location 1

Location 16319 W 70th StShreveport, LA 71129-2417 · Phone (318) 918-0058

Other Identifiers 1

Medicaid1509639LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, HMO Louisiana.Insurance ›

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 19D2198123

Gibson Family Practice Drg Medical LLC · Shreveport, LA
Active · expires Oct 28, 2026
CLIA Number19D2198123
Laboratory TypePhysician Office
Certificate Effective DateOctober 29, 2024
Certificate Expiration DateOctober 28, 2026
Laboratory DirectorWilliam L. Gibson
Laboratory Phone(318) 423-7733
Laboratory LocationGibson Family Practice Drg Medical LLC1549 Elizabeth Avenue, Shreveport, LA 71101
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

What is DRG MEDICAL LLC's NPI number?

The NPI number assigned to this healthcare provider is 1316418288, enumerated as an "organization" on December 17, 2018.

Where is the provider located?

The provider is located at 1549 ELIZABETH AVE SHREVEPORT, LA 71101 and the phone number is (318) 918-0058.

What is the provider's specialty?

Family Medicine with taxonomy code 207QA0401X and a focus in Addiction Medicine.

What insurance does DRG MEDICAL LLC accept?

The provider might be accepting Accepts: Blue Cross and Blue Shield of Louisiana, HMO. Please consult your insurance carrier or call the provider to verify.